FIELD OF THE INVENTION
[0001] The present invention relates to synthetic multiple tandem repeat peptides and methods
of synthesizing the peptides. The present invention also relates to uses of the peptides,
such as in vaccines and diagnostic tests for human cancers and infectious diseases
using the framework structure of the tandemly repeating synthetic peptides.
BACKGROUND INFORMATION
[0002] Mucins are large secreted and/or transmembrane glycoproteins with greater than 50%
of their molecular weight derived from O-linked carbohydrate attached to serine and
threonine residues (for a review see Strouss, G. J. and Dekker, Critical Reviews in
Biochemistry and Molecular Biology, 27½: 57-92, 1992). The bulk of the glycosylation
is contained within a domain composed of tandemly repeated sequences of 10-81 amino
acids per repeat (Gum, et al., J. Biol. Chem., 264: 6480-6487, 1989, Gum, et al. Biochem.
Biophys. Res. Commun. 171: 407-415, 1990, Lan, et al., J. Biol. Chem., 265: 15294-15299,
1990, Lan, et al. Cancer Res., 50: 2997-3001, 1990, and Porchet, et al., Biochem.
Biophys. Res. Commun., 175: 414-422, 1991). Mucins are produced by cells of epithelial
lineage and recently, expression of certain epitopes on one of the mucins, polymorphic
epithelial mucin (PEM) encoded by the muc-1 gene, has been identified as being associated
with tumors (Hilkens, et al., Cancer Res., 49: 786-793, 1989 and Jerome, et al., Cancer
Res., 51: 2908-2915, 1991).
[0003] Studies with monoclonal antibodies reactive with epithelial tumors and corresponding
normal tissues reveal that there can be different epitopes associated with mucins
from malignant cells as opposed to normal cells (Jerome, et al., Cancer Res., 51:
2908-2916, 1991, Girling, et al., Int. J. Cancer, 43: 1072-1076, 1989, Taylor-Papadimitriou,
J., Int. J. Cancer, 49: 1-5, 1991). This is in part due to aberrant glycosylation
in certain tumors which results in the exposure of the mucin tandem repeat protein
core on the cell surface (Hilkens, et al., Cancer Res., 49: 786-793, 1989, Girling,
et al., Int. J. Cancer, 43: 1072-1076, 1989, Sell, Progress Path., 21: 1003-1019,
1990, Devine, et al., Cancer Res. 51: 5826-56836, 1991, and Itzkowitz, et al., Gastroenterol.,
100: 1691-1700, 1991). The exposure of the protein core of certain mucins found on
malignant cells, combined with the ability of the immune system to respond to these
structures (Jerome, et al., Cancer Res., 51: 2908-2916, 1991 and Barnd, et al., PNAS
USA, 86: 7159-7163, 1989), offers a unique opportunity to utilize mucin-based vaccines
for specific immunotherapy of tumors.
[0004] The development of effective vaccine and immunotherapies for human cancers and infectious
agents often is dependent on the generation of protective immune responses to specific
domains of membrane proteins. Examples include: the tandem repeat (TR) domain of the
breast, pancreatic, and ovarian tumor antigen, human mucin muc-1 (Barnd et al., PNAS
USA, 86: 7159-7163, 1989; Jerome et al., Cancer Res., 51: 2908-2916, 1991), the principal
neutralizing domain of HIV-1 (Javaherian et al., PNAS USA, 86: 6768-6772, 1989; Javaherian
et al., Science, 250: 1590-1593, 1990) and the proline rich neutralization domain
of the feline leukemia virus external surface unit protein (gp-70) (Nunberg et al.,
PNAS, 81: 3675-3679, 1984; Elder et al., J. Virol., 61: 8-15, 1987; Strouss et al.,
J. Virol., 61: 3410-3415, 1987; Nick et al., J. Gen. Viral., 71: 77-83, 1990).
[0005] It was recently shown that protein core of the human muc-1 TR domain (Fontenot et
al., in press 1993A) and the feline leukemia virus PRN domain of gp-70 (Fontenot et
al., in press 1993B) form polyproline β-turn helixes (Matsushima et al., Function
and Genetics, 7: 125-155, 1990). Some common characteristics of the poly-proline β-turn
helix include: (1) Approximately 20-60% proline, and a high content of glycine, serine
and glutamine: (2) Low predicted α-helix and β-sheet secondary structure content and
a high predicted content of β-turns: (3) A circular dichroism spectrum consistent
with high turn content and low α-helix and β-sheet secondary structure content: (4)
Intrinsic viscosity values consistent with the formation of extended rod-shaped structures
(Matsushima et al., 1990).
[0006] In many cases, the use of the entire glycoprotein as an immunogen for the development
of effective vaccines and immunotherapies for human cancers and infectious agents
has proven either ineffective due to a lack of immunogenicity, or results in the enhancement
of infection and disease due to the inclusion of nonprotective epitopes (Osterhaus
et al. Vaccine, 7:137-141, 1989; Gilbert et al. Virus Research, 7:49-67, 1987; Burke,
D. Perspect. Biol. Med., 35:511-530, 1992).
[0007] The use of synthetic peptides as vaccines can circumvent many of the problems associated
with recombinant vaccines. The advantages of the use of synthetic peptides that correspond
to specific membrane protein domains include: selection and inclusion of only protective
epitopes; exclusion of disease enhancing epitopes and infectious material; and, synthetic
peptides antigens are chemically well defined and can be produced at a reasonable
cost (Arnon and Horwitz, Curr. Opin. Immunol., 4:449-453, 1992).
[0008] The disadvantages are that small synthetic peptides may not contain the precise amino
acid sequences necessary for processing and binding to major histocompatibility complex
(MHC) class I and class II proteins, for presentation to the immune system (Rothbard,
Biotechnology, 20:451-465, 1992). Another disadvantage is that the solution structure
of small peptides may be different than that found in the native protein and therefore
not induce humoral immunity of the proper specificity and affinity to provide protective
immunity (Bernard et al. Aids Res. and Hum. Retroviruses, 6:243-249, 1990).
[0009] However, peptide fragments of larger proteins which are rich in proline, peptides
containing b-turns, and peptides with proline rich direct sequence repeats have been
shown to maintain native structure in solution and be immunogenic (Broekhuijsen et
al., J. Gen. Virol., 68:3137-3145, 1987; Bhandary et al., Int. J. Peptide Protein
Res. 36:122-127, 1990; Dyson et al., J. Mol. Biol., 201:201-217, 1988; Dyson et al.,
Biochemistry 31:1458-1463, 1992; Mayo et al., Biochemistry 30:8251-8267, 1991; Richman
and Reese, Proc. Natl. Acad. Sci. U.S.A., 85:1662-1666, 1988) and seem to have potential
as vaccine candidates. These include the human mucin and tumor antigen (muc-1) tandem
repeat (TR) domain (Gendler et al. J. Biol. Chem., 26:12820-12823, 1988; Lan et al.,
Cancer Res. 50:2997-3001, 1990; Barnd et al., Proc. Natl. Acad. Sci. U.S.A., 86:7159-7163,
1989; Jerome et al., Cancer Res., 51:2908-2916, 1991), the retroviral proline rich
domains of feline leukemia virus gp70 (Donahue et al., J. Virol., 62:722-731, 1988),
murine leukemia virus gp70 (Battini et al., J. Virol., 66:1468-1475, 1992), and Gibbon
ape leukemia virus (Delassus et al., Virology, 53:205-213, 1989), and the tandem repeats
of the H.8 lipoprotein of Neisseria gonorrhoeae (Baehr et al., Mol. Microbiol. 3:49-55).
[0010] Mucins are glycoproteins abundantly present at the luminal side of ductal epithelial
cells and on tumors derived from this cell type. Numerous mucin specific antibodies
have been derived following immunization of animals with normal or malignant epithelial
cells. They were initially thought to recognize different molecules but were determined
in most instances to react with various carbohydrate mucin epitopes. Heterogeneity
of mucin molecules as defined by carbohydrate specific antibodies appeared to be extensive.
Antibodies were reported which reacted with both normal and tumor mucins, some that
exhibited apparent tumor specificity, some that showed organ specificity, and others
that reacted with mucins from all organ sites. The most discriminating were antibodies
which reacted with peptide epitopes on the mucin polypeptide core. Some of these antibodies
resulted from immunizations with whole mucin or epithelial cell tumors, providing
evidence that some peptide epitopes must be exposed on this highly glycosylated molecule
and on the tumor cell surface (Kufe D, Inghirami M, Abe D, Hayes H, Justi-Wheeler
H and Schlom J. Differential reactivity of a novel monoclonal antibody (DF3) with
human malignant versus benign tumors. Hybridoma 3: 223, 1984; Hilkens J, Buijs F,
Hilgers J, et al. Monoclonal antibodies against human milk-fat globule membranes detecting
differentiation antigens of the mammary gland and its tumors. Int. J. Cancer 34: 197,
1984; Burchell J, Gendler S and Taylor-Papadimitriou J. Development and characterization
of breast cancer reactive monoclonal antibodies directed to the core protein of the
human milk mucin. Cancer res. 47: 5476, 1987; Girling A, Bartkova J, Burchell J, et
al. A core protein epitope of the polymorphic epithelial mucin detected by the monoclonal
antibody SM-3 is selectively exposed in a range of primary carcinomas. Int. J. Cancer
43: 1072, 1989; Xing PX, Tjandra JJ, Stacker SA, et al. Monoclonal antibodies reactive
with mucin expressed in breast cancer. Immunol. cell Biol. 67: 183, 1989; Gendler
SJ, Burchell JM, Duhig T, et al. Cloning of a partial CDNA encoding differentiation
and tumor-associated mucin glycoproteins expressed by human mammary epithelium. Proc.
Natl. Acad. Sci. USA 84: 6060, 1987).
[0011] The nature of mucins produced by different organs, as well as possible differences
between tumor derived and normal epithelial cell-derived mucins became clear only
recently, following isolation of cDNA clones for breast (Gendler SJ, Lancaster CA,
Taylor-Papadimitrou J, et al. Molecular cloning and expression of human tumor-associated
polymorphic epithelial mucin. J. Biol. Chem. 265: 15286* 1990; Siddiqui J, Abe M,
Hayes E, Shani E, Yunis E and Kufe D. Isolation and sequencing of a CDNA coding for
the human DF3 breast carcinoma-associated antigen. Proc. Natl. Acad. Sci. USA 85:
2320, 1988; Ligtenberg MJL, Vos HL, Gennissen AMC and Hilkens J. Episialin, a carcinoma-associated
mucin, is generated by a polymorphic gene encoding splice variants with alternative
amino termini. J. Biol. Chem. 265: 5573 1990) pancreas (Gum JR, Hicks JW, Swallow
DM, et al.Molecular cloning of CDNAS derived from a novel human intestinal mucin gene.
Biochem. Biophys. Res. Commun. 171: 407, 1990) small intestine (Gum JR, Byrd JC, Hicks
JW, Toribara NW, Lamport DTA and Kim TS. Molecular cloning of human intestinal mucin
cDNAs. Sequence analysis and evidence for genetic polymorphism. J. Biol. Chem. 264:
6480, 1989; Gum JR, Hicks JW, Swallow DM, et al. Molecular cloning of CDNAS derived
from a novel human intestinal mucin gene. Biochem. Biophys. Res. Commun. 171: 407,
1990) and bronchoepithelial cell mucin (Porchet N, Van Cong N, Dufosse J, et al. Molecular
cloning and chromosomal localization of a novel human tracheo-bronchial mucin CDNA
containing tandemly repeated sequences of 48 base pairs. Biochem. Biophys. Res. Comnun.
175: 414, 1991). Comparison of the cDNA'S indicated important similarities in the
overall structure of the molecule, but also showed that at least four different genes
located on different chromosomes encode mucin molecules, and that the expression of
these genes is tissue specific. The sequences of all the genes cloned from breast
adenocarcinomas were nearly identical, and those in turn were identical to the sequence
of the gene cloned from a pancreatic adenocarcinoma. They are also found in colon
carcinomas. They were named MUC 1. Two other genes isolated from a small intestine
CDNA library and expressed at low levels in colon carcinomas (MUC 2 and MUC 3) are
distinct from one another, and from the fourth, tracheobronchial mucin gene MUC 4.
[0012] The most unifying feature of all the mucin genes and proteins is the presence of
numerous (between 40 and 100) tandem repeats which comprise approximately twothirds
of the molecule. The amino acid sequence of the repeats is abundant in serines and
threonines, sites of 0-linked glycosylation. The amino terminus consists of a putative
signal peptide followed by degenerate tandem repeats and the carboxyl terminus contains
degenerate tandem repeats, a unique transmembrane sequence and cytoplasmic tail. Table
A below shows the tandem repeat structure of the breast and pancreas mucin cDNA (MUC
1). It consists of 60 nucleotides encoding a polypeptide of 20 amino acids in length.
Five O-linked glycosylation sites (2 serines and 3 threonines) are present per repeat.
[0013] Table A compares the tandem repeat animo acid sequence encoded by the four genes.

[0014] L. Ding et al. (Cancer Immunology and Immunotherapy, Vol. 36, December 1992, p.9-17)
teaches the use of the synthetic peptide SP1-5 containing four 20-aa MUC 1 tandem
repeats in MAP configuration (dendritic multiple antigenic peptide). This peptide
was found to be a good immunogen for the induction of specific delayed-type hypersensitivity
(DTH) reactions measured using either synthetic peptides or MUC1 transfected cells.
The SP1-5 peptide contains the B and T cell epitope of the MUC1 core peptide, PDTRP.
Vaccine compositions are mentioned.
[0015] The present invention provides methods for synthesizing long peptides having poly-proline
β-turn helices, and methods for modifying these synthetic poly-proline helices for
the design of new antigens by tandemly repeating important B- or T-cell epitopes or
coupling B- and T- cell epitopes to produce antigens of larger sizes.
[0016] The invention is based on the novel method of synthesizing very long peptides of
multiple tandem repeats having a poly-proline β-turn structural motif, such as human
mucin (muc-1) peptides. The peptides of the invention attain native conformation in
the absence of glycosylation, reflecting the structure seen in native mucin.
[0017] The invention also relates to methods of designing antigens which are able to induce
an immune response. This aspect of the invention is based on the previously identified
MHC-unrestricted T-cell reactivity against mucin seen in patients with breast and
pancreatic adenocarcinomas expressing this protein (Jerome et al., Cancer Res., 51:2908-2916,
1991; Barnd et al., Proc. Natl. Acad. Sci. U.S.A., 86:7159-7163, 1989; Jerome et al.,
Cancer Res., 52:5985-5990, 1992) in addition to the newly discovered characteristic
of the structure of the poly-repeat synthetic mucin peptide. (Fontenot et al., "Biophysical
Characterization of One-, Two-, and Three-Tandem Repeats of the Human Mucin (MUC-1)
Protein Core," submitted to Cancer Research.)
[0018] The poly-repeat mucin peptide allows the removal of several amino acids from the
primary epitope of mucin without interfering with the structure of the tandem repeats
important for native conformation and for the MHC-unrestricted T-cell reactivity.
It is possible to replace the uninterfering amino acids of the mucin epitope with
amino acids from epitopes of important antigens allowing an unrestricted T-cell reactivity
to the newly designed immunogen.
SUMMARY OF THE INVENTION
[0019] The invention relates to a synthetic muc-1 peptide comprising at least two 20-amino
acid tandem repeats of muc-1, which synthetic muc-1 peptide is capable of attaining
native conformation in the absence of glycosylation. For instance, the synthetic muc-1
peptide may comprise 2, 3, 4, 5 or more tandem repeats of muc-1.
[0020] In another embodiment, the invention relates to a synthetic muc-1-like peptide that
comprises at least two 20-amino acid tandem repeats of muc-1 and a foreign amino acid
sequence, which peptide is capable of attaining native conformation in the absence
of glycosylation. For instance, the synthetic muc-1-like peptide may comprise 2, 3,
4, 5 or more tandem repeats of muc-1. The foreign amino acid sequence may be an epitope,
such as, for instance an antigenic epitope corresponding to a virus (for example,
HIV), a bacteria, a parasite, or cancer (for example, pancreatic cancer, breast cancer,
ovarian cancer or colon cancer). Thus, the peptide is muc-1-like, or an analog of
muc-1 where a "foreign" epitope is appropriately inserted to form an immunologically
native synthetic antigen.
[0021] The synthetic muc-1 and muc-1-like peptides of the present invention may be 40, 60,
80 or, preferably, 105 amino acids in length, or even larger and may be covalently
linked to a pharmaceutically acceptable adjuvant.
[0022] In a further embodiment, the present invention relates to a method of producing a
mucin peptide having at least two tandem repeats, which peptide is capable of attaining
native conformation in the absence of glycosylation. The method relates to standard
solid state synthesis protocols, with several modifications. Conventional methodology
is employed with the following modifications. Synthesis is stopped when the primary
sequence reaches 30 amino acids in length. One half of the resin-bound 30 amino acid
peptide is then removed. A monitor step is then employed to monitor the completeness
of the reaction. The reaction cycle is then continued until the desired length is
obtained.
[0023] In another embodiment, the present invention relates to a method of producing muc-1-like
peptides having at least two tandem repeats and a foreign amino acid sequence, which
muc-1-like peptide is capable of attaining native conformation in the absence of glycosylation.
The method relates to standard solid state synthesis protocols, with the several modifications
mentioned hereinabove. The foreign amino acid sequence may be an epitope.
[0024] The invention also relates to the mucih peptide produced by the method the above-described
methods, which peptide may be 40, 60, 80 or, preferably, 105 amino acids in length,
although longer lengths are possible.
[0025] In another embodiment, the present invention relates to an immunogenic composition
capable of inducing in a mammal (such as a human or a mouse) antibodies against an
epitope (such as a vaccine), which composition comprises a synthetic muc-1-like peptide.
The present invention further relates to an immunogenic composition capable of inducing
in a mammal (such as a human or a mouse) cytotoxic T cells (CTL) against an epitope
(such as a vaccine), which composition comprises a synthetic muc-1-like peptide. The
synthetic muc-1-like peptide comprises at least two 20-amino acid tandem repeats of
muc-1 and is capable of attaining native conformation in the absence of glycosylation.
The synthetic muc-1-like peptide may further comprise the amino acid sequence for
an epitope. The synthetic muc-1-like peptide may be 40, 60, 80 or, preferably, 105
amino acids in length, although longer lengths are possible.
[0026] In yet a further embodiment, the invention relates to a method of detecting the presence
of antibodies to a specific disease (for instance, cancer such as pancreatic, breast
or colon cancer) in a biological test sample, comprising the steps of:
a) contacting the above-described synthetic muc-1-like peptide containing an epitope
with the biological test sample, which epitope is reactive with antibodies to the
disease, under conditions such that a synthetic muc-1-like peptide-antibody complex
is formed, and
b) detecting the formation of the synthetic muc-1-like peptide-antibody complex, which
complex is indicative of the presence of antibodies to the specific disease.
[0027] The invention also relates to a vaccine comprising a synthetic muc-1-like peptide
of at least two 20-amino acid tandem repeats of muc-1 with the amino acid sequence
for an epitope (corresponding to, for instance, a virus, a cancer or a bacteria) appropriately
inserted to form a native synthetic antigen, wherein said synthetic muc-1-like peptide
is capable of attaining native conformation in the absence of glycosylation. Preferably,
the synthetic muc-1-like peptide is 105 amino acids in length and comprises at least
five 20-amino acid tandem repeats of muc-1 with the amino acid sequence for an epitope
appropriately inserted to form a native synthetic antigen. The synthetic muc-1-like
peptide may comprise five sequential 20-amino acid tandem repeats of muc-1 and five
additional amino acids, wherein said five additional amino acids are placed before
or after the five sequential 20-amino acid tandem repeats.
[0028] The invention also relates to a vaccine comprising a synthetic muc-1-like peptide
of 105 amino acids and an adjuvant, which muc-1-like peptide comprises at least five
sequential 20-amino acid tandem repeats of muc-1 and five additional amino acids,
and is capable of attaining native conformation in the absence of glycosylation. The
five additional amino acids may be placed before or after the five sequential 20-amino
acid tandem repeats.
BRIEF DESCRIPTION OF THE DRAWINGS
[0029]
Figure 1. The analytical HPLC chromatograms of the crude synthetic peptide products of the
twenty, forty, and sixty amino acid peptides are shown above. The electrospray mass
spectra of the largest HPLC peak fractions (indicated by arrow) are shown below. In
each case the mass obtained was the expected molecular weight (20 mer = 1886 daltons,
40 mer = 3766 daltons, 60 mer = 5625 daltons).
Figure 2. 600-MHz cosy 1H-NMR spectra of muc-1 60 amino acid peptide dissolved in deuterated 0.1M phosphate
buffer pH 7.2, in D2O. The cross peaks show scalar correlation between amide-1H and 1Hα. These amide protons are protected from exchange with the solvent by the folded
structure of the mucin peptide.
Figure 3. 1H-NMR spectra of mucin peptides dissolved in deuterated 0.1M phosphate buffer pH 6.89,
in D2O showing the region of the β-protons of aspartic acid and histidine. Development
of structure depends on the number of tandem repeats in the peptide.
Figure 4. 1H-NMR spectra of mucin peptides dissolved in deuterated 0.1M phosphate buffer pH 6.89,
in D2O showing the region of the C2 (8.2-8.4 ppm) and C4.
Figure 5. 1H-NMR spectra of mucin peptides dissolved in H2O and 0.1M phosphate buffer pH 6.8. (A) twenty amino acid peptide corresponding to
one tandem repeat. (B) Forty amino acid peptide corresponding to two tandem repeats.
Sixty amino acid peptide corresponding to three tandem repeats.
Figure 6. Circular dichroism spectrum of mucin 60 amino acid peptide in 0.01M phosphate buffer
pH 7.2 at 25, 55, 75 and 90°C.
Figure 7. The sequence of three-tandem repeats of the human mucin muc-1 gene modeled into a
poly-type I turn conformation using the Tripos molecular graphics program Sybyl.
Figure 8. The analytical HPLC chromatogram of the crude synthetic peptide products of (a) mucin
105 residues (b) PRN60, 60 residues (c) H2D8, 72 residues (d) H2DAS7, 70 residues
(E) electrospray mass spectrum of the mucin 105 major fraction (f) electrospray mass
spectrum of PRN60 major fraction (g) electrospray mass spectrum of H2D8 major fraction
(h) electrospray mass spectrum of H2DAS7 major fraction.
Figure 9. Circular dichroism spectra of (a) mucin 105, (b) PRN60, (c) H2D8, (d) H2DAS7 at 25,
55, 75, and 90°C.
Figure 10. The molar ellipticity [θ] of (1) control peptide (2) mucin 20 residues (3) mucin
60 residues (4) mucin 105 residues, (5) PRN60, (6) H2DAS7 at 25°C.
Figure 11. This figure demonstrates that at least 10% of breast cancer patients have the antibody
against mucin. Serum from breast cancer patients was reacted with the 105 amino acid
synthetic peptide, and specific reactivity detected by ELISA assay. Normal serum did
not react with the peptide and was used as a control. The same results were obtained
with sera from pancreatice and colon cancer patients.
Figure 12. This figure shows that the antibody against mucin is only detectable with the peptides
of the invention, where the 105 amino acid peptide demonstrates the best results.
Previous experiments performed by the inventors and others by reacting patient sera
with short mucin peptides or purified mucin molecules from sera of cancer patients,
detected no specific antibody.
Figure 13. This figure shows that the 105 amino acid peptide of the invention is useful in determining
precisely the specificity of serum antibodies. Short peptides are used to inhibit
serum reactivity with the 105 peptide. Serum is mixed first with short mucin peptides
representing difference regions of the tandem repeat. The mixture is then reacted
on an ELISA plate with the long 105 amino acid peptide. Short peptides with epitopes
recognized by antibodies in patient's sera can interfere with the antibody binding
to the long peptide.
Figure 14. This figure shows that the 105 amino acid peptide of the invention is useful in determining
the precise isotype of the anti-mucin antibody. The long peptide binds the specific.
antibody from the patient's sera. Other antibodies are recovered by washing the ELISA
plate. Secondary antibodies which are commercially available are then added. They
have specific reactivities with various antibody isotypes. The end result is that
antibodies from sera which bound to the 105 amino acid peptide can be determined to
be either IgG, IgM, IgD, IgA or IgE, or mixtures of these. The figure shows that antibodies
generated by the patients against mucin are all IgM.
DETAILED DESCRIPTION OF THE INVENTION
[0030] The invention is based in part on the discovery that an additional characteristic
of the polyproline β-turn helix is the fidelity of synthesis to lengths not previously
attained with Fmoc solid phase peptide synthesis (Fields et al., Principles and practice
of solid-phase peptide synthesis. In Synthetic Peptides, G.A. Grant, eds., W.H. Freeman
and Co., New York, pp. 77-183, 1992). Two additional characteristics of the poly-proline,
β-turn helix are: (1) the ability to form an ordered long-lived conformation in solution
and the protection of protons in while dissolved in D
2O as determined by
1H-NMR spectroscopy (Fontenot et al., in press, 1993A & B); and (2) a large negative
CD band at about 198 nm in aqueous solution. The absence of two separate negative
CD bands at 220 nm and 208 nm and the lack of a positive band at 192 nm rules out
α-helical character to either mucin, PRN60 or H2Dmuc7. In addition, no β-sheet structure
is evident due to the absence of the negative band at 216 nm and the large positive
band between 195 and 200 nm (Woody, Circular Dichoism of Peptides, In "The Peptides:
Analysis, Synthesis, Biology," 7: 16-104, 1985; Johnson, Am. Rev. Biophys. Chem.,
17: 145-166, 1988).
[0031] Previous model peptide studies with the tandem repeat peptide (PKLKL)n concluded
that a single negative CD band at 198 nm was indicative of random coil. However, Dukor
& Keiderling (Biopolymers, 31: 1747-1761, 1991) have shown that small peptides tend
to assume transient left-handed 3,-helixes like that found in poly-proline II, which
consists of all trans proline (Dukor & Keiderling, Biopolymers, 31: 1747-1761, 1991).
Thus, "random coil" peptides display similar conformations and CD spectra as polyproline
β-turn helixes but at much lower intensity as demonstrated in Figure 10. Clearly,
the large negative CD band indicates secondary structure rather than the absence of
structure.
[0032] The two-dimensional
1H-NMR (COSY) experiment in D
2O (an example is described below) using a 60 amino acid synthetic peptide shows that
the mucin tandem repeat domain can fold into a stable structure, and that this structure
is capable of sequestering protons from exchange by deuterium for more than 24 hours.
In addition, one-dimensional
1H-NMR experiments in D
2O with the synthetic peptide analogs corresponding to one-, two-, and three-repeats
of the tandem repeat domain, show that formation of the structure is occurring with
increasing number of repeats.
[0033] The structural changes appear to be occurring throughout the length of the 20 amino
acid repeat domain, as changes can be detected throughout the molecule by focusing
on the β-protons in the region of 2.4 to 3.3 ppm from DSS (Figure 3). By concentrating
on the β-protons, the inventors have taken advantage of the peculiar repetitive nature
of this protein domain. One twenty-amino acid peptide contains all of the protons
that can contribute to the
1HNMR spectrum and any differences observed in the spectrum of peptides corresponding
to one-, two-, or three-tandem repeats can only be attributed to changes in the local
magnetic environment imposed through the development of secondary structure along
the polypeptide backbone. Clearly, the
1H-NMR spectra reveal that the structures of peptides containing one-, two-, and three-repeats
are different. Yet, peptides containing multiple histidyl residues whose C2 and C4
resonances resolve into single peaks suggests that the environment of each histidine
in multiple repeat peptides are equivalent. It is believed that the
1H-NMR results show that the precise conformation of a residue depends on the number
of repeats in the peptide.
[0034] Previous studies on muc-1 core structure, using an 11-amino acid fragment of muc-1
tandem repeat, were able to show that a reverse-turn structure formed when dissolved
in dimethyl sulfoxide, from D2 through P4, and that P4 existed in the trans conformation
(Tendler, 1990 and Scanlon, et al., 1992). Using much larger synthetic peptides, the
inventors have demonstrated that there is a gradation of structures that depends on
the size of the peptide.
[0035] This data is strongly supported by the monoclonal antibody binding data. Many of
the monoclonal antibodies failed to react with a peptide corresponding to just one
repeat, even when the epitope was present, but increasing number of repeats resulted
in increased antibody reactivity. This behavior is consistent with that found by other
authors which show that providing amino acids C-terminal to the first proline forms
the major immunodominant epitope (Price, et al., Molecular Immunology, 27: 795-802,
1990 and Xing, et al., Immunology, 72, 1991).
[0036] The
1H-NMR experiments described below clearly show that the mucin tandem repeat domain
assumes an ordered structure in solution, and the form of the structure may be further
understood by analysis of the mucin sequence, the shape of the molecule obtained from
intrinsic viscosity measurements and electron microscopy, and the circular dichroism
studies.
[0037] In one embodiment, the invention relates to synthetic muc-1 peptides comprising at
least two 20-amino acid tandem repeats of muc-1, which synthetic muc-1 peptide is
capable of attaining native conformation in the absence of glycosylation. For instance,
the nuc-1 peptide may comprise 2, 3, 4, 5 or more tandem repeats of muc-1. The synthetic
muc-1 peptides of the present invention may be 40, 60, 80 or, preferably, 105 amino
acids in length, or even longer, and may be covalently linked to a pharmaceutically
acceptable carrier molecule or adjuvant, and may be part of a kit comprising the synthetic
muc-1-like peptides and conventional reagents.
[0038] Peptide repeats which should be used are those that are poly-proline β-turn helixes.
Some common characteristics of peptides having polyproline β-turn helixes include:
1. Approximately 20-60% proline, and a high content of glycine, serine and glutamine;
2. Low predicted a-helix and b-sheet secondary structure content and a high predicted
content of b-turns;
3. A circular dichroism spectrum consistent with high turn content and low a-helix
and b-sheet secondary structure content;
4. Intrinsic viscosity values consistent with the formation of extended rod-shaped
structures (Matsushima et al. Proteins: Structure, Function and Genetics 7:125-155,
1990).
[0039] Examples of sequences of peptides which can be synthesized by RaMPS are shown in
Table 1. The naturally occurring mucin tandem repeat is shown in Table 1, No. 1. The
entire proline rich neutralization domain of Feline leukemia virus and a 42 amino
acid N-terminal fragment of this domain is shown in Table 1, No. 2, and 3 respectively.
Other mucin peptides, such as muc-2, muc-3, or muc-6, are tandem repeats of various
lengths. Although these mucin peptides do not have all the same characteristics of
muc-1, regions of their sequences can be replaced, such as by proline. Thus, the natural
length of the tandem repeat of each particular mucin may be preserved.
[0040] In another embodiment, the invention relates to a synthetic muc-1-like peptide that
comprises at least two 20-amino acid tandem repeats of muc-1 and a foreign amino acid
sequence, which peptide is capable of attaining native conformation in the absence
of glycosylation. For instance, the muc-1-like peptide may comprise 2, 3, 4, 5 or
more tandem repeats of muc-1. The foreign amino acid sequence may be an epitope, such
as, for instance, an antigenic epitope corresponding to a virus (for example, HIV),
a bacteria, a parasite, or cancer (for example, pancreatic cancer, breast cancer,
ovarian cancer or colon cancer).
[0041] The synthetic muc-1-like peptides of the present invention may be 40, 60, 80 or,
preferably, 105 amino acids in length, and may be covalently linked to a pharmaceutically
acceptable carrier molecule or adjuvant, and may be part of a kit comprising the synthetic
muc-1-like peptides and conventional reagents.
[0042] In a further embodiment, the present invention relates to a method of producing a
mucin peptide having at least two tandem repeats, which peptide is capable of attaining
native conformation in the absence of glycosylation. The method relates to standard
solid state synthesis protocols, with several modifications.
[0043] Conventional methodology is employed with the following modifications. Synthesis
is stopped when the primary sequence reaches 30 amino acids in length. One half of
the resin-bound 30 amino acid peptide is then removed. A monitoring step is then employed
to monitor the completeness of the reaction. Then, the reaction cycle is continued
until the desired length of peptide is obtained.
[0044] The method comprises the steps of:
i) activating an amino acid of interest;
ii) introducing the activated amino acid of interest to appropriate solid phase;
iii) reacting under appropriate conditions until completion;
iv) monitoring for completeness of reaction;
v) repeating steps i) to iv) with the next amino acid of interest, until a 30 amino
acid peptide is obtained, at which point half of the 30 amino acid peptide is removed;
and
vi) continuing the reaction cycle until a mucin peptide of desired length having at
least two tandem repeats and capable of attaining native conformation in the absence
of glycosylation is formed.
[0045] By way of example, the method of the present invention may be achieved by the following
protocol, using manual methodology on a Rapid Multiple Peptide Synthesizer (RaMPS).
The Coupling Reaction
[0046] 0.25 mmole of the appropriate OPfp or Odhbt amino acid ester is dissolved in 1 ml
of DMF and added to a standard RaMPS resin cartridge. 0.2 ml of 0.5M 1-hydroxybenzotriazole
(HOBT) in DMF is added to the cartridge. 2ml of DMF is used to rinse the remaining
OPfp ester from the amino acid vial into the RaMPS resin cartridge. After the cartridge
is capped securely, it is shaken for 2 hours at room temperature.
[0047] The RaMPS processor is then turned off, and the cartridge uncapped, opened and drained.
The solvent is aspirated under a vacuum.
[0048] The resin is soaked for 30-45 sec with DMF, drained and aspirated. This is repeated
twice. (3 cycles total)
[0049] Next, the resin is soaked for 30-45 sec with Methanol, drained, and aspirated. This
is repeated. (2 cycles total)
[0050] Next, the reaction is monitored for completeness using the Kaiser or Isatin Test.
If the coupling was incomplete, the next step is to be done and the first 4 steps
are repeated (through the soaking of the resin in methanol for 30-45 seconds, draining
and aspirating). If coupling was complete, the next step is to be done.
[0051] The resin is soaked for 30-45 sec with DMF, drained and aspirated. This is repeated
three times. (4 cycles total)
[0052] The resin is then soaked 30-45 sec with 50% piperidine/DMF, and drained.
[0053] Then the RaMPS cartridge valve is closed, and 3 ml 50% piperidine/DMF is added. The
cartridge is capped and shaken for 20 minutes. The cartridge is then drained.
[0054] Next, the RaMPS resin is soaked for 30-45 seconds with 100% DMF. drained and aspirated.
This is repeated twice. (three cycles total)
[0055] A monitoring step is added at this point to detect incomplete deblocking reactions
and to prevent human errors.
[0056] (If, at this point, the last amino acid has been coupled to the resin, cleavage of
the completed peptide should be done next.)
[0057] RaMPS resin are then soaked for 30-45 sec with 100% methanol, drained and aspirated.
This is repeated. (two cycles total)
[0058] RaMPS resin are soaked for 30-45 sec with 100% DMF, drained and aspirated. This is
repeated three times. (four cycles total)
[0059] The next amino acid may then be added using the procedure outlined above, beginning
with the first step.
[0060] After a length of 30 amino acids is reached, half of the resin is removed and placed
in a separate cartridge. The concentration of amino acid is kept the same but the
ratio of [AA/[Peptide chain on resin] is doubled].
Cleavage of the Completed Peptide
[0061] The RaMPS™ resin is soaked for 30-45 sec with 100% methanol, drained and aspirated.
This is repeated twice. (3 cycles total).
[0062] The resin is aspirated for 10 minutes so that it will dry.
[0063] After the valve of the RaMPS cartridge is closed, the following is added: 2.85 ml
trifluoroacetic acid (TFA); 135 ul phenol (H2O liquified) or thioanisole, as appropriate;
15 ul ethanedithiol.
[0064] The RaMPS cartridge is then capped and rocked at room temperature as noted.
| RapidAmide™ resin |
16 hours |
| Hang resin |
3 hours |
[0065] Next, RaMPS cartridge is removed from the RaMPS processor and suspended over a 50-ml
polypropylene tube.
[0066] The valve is opened, uncapped, and the solvent is drained into the tube.
[0067] The resin is next rinsed with 5.0 ml TFA, and drained into the tube. This is repeated.
[0068] The RaMPS cartridge may then be discarded.
[0069] The volume of TFA may then be reduced to 1-2 ml with a gentle stream of inert gas.
[0070] Next, 25 ml diethyl ether is added to the tube and mixed. The tube is then set on
dry ice/aceton for 5 minutes or until the peptide precipitates.
[0071] The top ether layer may be removed and discard.
[0072] The previous two steps are to be repeated three times. (four cycles total)
[0073] Next, 25 ml ethyl acetate/diethyl ether (1.5:1) is added to the tube, and mixed.
The tube is then set on dry ice/acetone for 5 minutes or until the peptide settles.
[0074] The top ether layer may be removed and discard.
[0075] The previous two steps are to be repeated. (two cycles total)
[0076] Next, 1.0 ml H
2O and 25 ml diethyl ether are added to the tube. The tube is then set on ice 5 minutes
or until the layers separate. The top ether layer is discarded.
[0077] Any remaining ether is evaporated with gentle stream of inert gas.
[0078] The peptide may then be lyophilized from H
2O or put in a Speed-Vac.
[0079] The method of the present invention represents a breakthrough in the routine production
of synthetic peptides of lengths 60 to 105 amino acids and greater, as long as native
conformation structure in the absence of glycosylation is maintained. Typically, the
efficiency of peptide synthesis decreases by 5% for each amino acid coupling past
20. (Grant, G.A., Evaluation of the Finished Product, in "Synthetic Peptides, A User's
Guide" (1992), G.A. Grant eds., W.H. Freeman and Company, New York, pp. 185-258.)
Therefore, with 5% error/per coupling, attempting to produce a peptide having 40 amino
acids would result in none of the desired product.
[0080] Currently, the most common method to increase the efficiency for the production of
longer peptides (for instance, peptides of 40 to 60 amino acids in length) is to perform
two couplings of the same amino acid sequentially. Unfortunately, this results in
increasing the error at a given step and the frequency of certain side reactions with
difficult amino acid couplings. Consequently, the inventors were quite surprised at
the efficiency with which they were able to produce mucin to 105 amino acids. The
longest peptide previously produced by Fmoc synthesis was 86 amino acids. (Field et
al., Principles and Practice of Solid-Phase Peptide Synthesis," in "Synthetic Peptides,
A User's Guide" (1992), G.A. Grant, eds., W.H. Freeman and Company, New York, pp.
77-183.) In order for this to be accomplished, the fidelity of each step in synthesis
had to be close to 100%. This can be achieved with engineered sequences as long as
the proline content is relatively high (for instance, 15% or greater).
[0081] In another embodiment, the present invention relates to a method of producing mucin-like
peptides having at least two tandem repeats and a foreign amino acid sequence, which
mucin-like peptide is capable of attaining native conformation in the absence of glycosylation.
The method relates to standard solid state synthesis protocols, with several modifications.
[0082] Conventional methodology is employed with the following modifications. Synthesis
is stopped when the primary sequence reaches 30 amino acids in length. One half of
the resin-bound 30 amino acid peptide is then removed. A monitoring step is then employed
to monitor the completeness of the reaction. Then, the reaction cycle is continued
until the desired length of peptide is obtained.
[0083] The method comprises the steps of:
i) activating an amino acid of interest;
ii) introducing the activated amino acid of interest to appropriate solid phase;
iii) reacting under appropriate conditions until completion;
iv) monitoring for completeness of reaction;
v) repeating steps i) to iv) with the next amino acid of interest, until a 30 amino
acid peptide is obtained, at which point half of the 30 amino acid peptide is removed;
and
vi) continuing the reaction cycle until a mucin peptide of desired length having at
least two tandem repeats and a foreign amino acid sequence, and is capable of attaining
native conformation in the absence of glycosylation is formed.
[0084] By way of example, the above-described protocol may be employed to achieve the present
invention.
[0085] The foreign amino acid sequence may be an epitope, such as, for instance an antigenic
epitope corresponding to a virus (for example, HIV), a bacteria, or cancer (for example,
pancreatic cancer, breast cancer, ovarian cancer or colon cancer). (Baehr et al.,
(1989) Mol. Microbiol. 3: 49-55) Epitopes which can be incorporated into the multiple
tandem repeat synthetic peptide are shown in Table 2.
[0086] For example, T cell epitopes would be quite short, often only 3-4 amino acids in
length. B-cell epitopes, on the other hand, are typically longer, although some can
be as short as 3-5 amino acids.
[0087] The invention also relates to the mucin peptides produced by the above-described
methods, which peptides may be 40, 60, 80 or, preferably, 105 amino acids in length,
although longer lengths are possible as long as the secondary structure is not disrupted.
[0088] In addition, the invention presents practical methodology for producing a class of
synthetic peptides that contain important antigens for vaccine and diagnostic development
for human cancers and infectious diseases (Finn, Biotherapy 4:239-249 (1992)). The
poly-proline helix offers a potential framework structure for designing new antigens
by tandemly repeating important B- or T-cell epitopes or coupling of B- and T- cell
epitopes to produce antigens of larger sizes.
[0089] Thus, in another embodiment, the present invention relates to an immunogenic composition
or molecule capable of inducing in a mammal antibodies against an epitope (such as
a vaccine), which composition or molecule comprises a synthetic muc-1-like peptide.
The synthetic muc-1-like peptide comprises at least two 20-amino acid tandem repeats
of muc-1 and the amino acid sequence for the epitope, and the synthetic muc-1-like
peptide is capable of attaining native conformation in the absence of glycosylation.
The synthetic muc-1-like peptide may comprise 2, 3, 4, 5 or more muc-1 tandem repeats,
and may be 40, 60, 80 or, preferably, 105 amino acids in length, although longer lengths
are possible. The immunogenic molecule can be administered with an adjuvant.
[0090] Mucin tandem repeat polypeptide core region is immunogenic and HLA-unrestricted because
it has a secondary structure rich in prolines, which is stable, assumes native configuration,
is a structural, not only a sequence repeat, and due to all of this is capable of
direct binding and cross-linking of T cell and B cell antigen receptors. For instance,
by the methods of the present invention, a synthetic peptide may be produced, 105
amino acids in length, containing 5 tandem repeats of 20 amino acids in length each,
and five amino acids (such as, for instance, GVTSA, which may be placed on the back
end or, preferably, the front end of the peptide). The longest mucin synthetic peptide
reported to date has two repeats; more than two tandem repeats are critical for the
peptide to assume a native structure and thus react properly with antibodies, to induce
proper antibodies, and to stimulate cellular immunity.
[0091] This method of synthesis which is especially effective for peptides with characteristically
placed prolines. Furthermore, the present invention can be utilized for synthesis
of other very long peptides in which a particular short sequence can be synthesized
on a long mucin-like backbone which can give the peptides a more native configuration
and desired reactivity with antibodies or cells of the immune system. The synthesis
of complex peptides using a polyproline β-turn helix structural motif constitutes
a novel synthetic strategy that can produce remarkably high levels of efficiency and
precision in the synthesis of exceedingly large peptides (for instance, longer than
40 amino acids).
[0092] The 105 amino acid long synthetic mucin peptide can be used as a tumor specific vaccine
for patients with pancreatic, breast, ovarian and colon cancers. Previous studies
have shown that epitopes on the mucin polypeptide core are targets for tumor specific
cytotoxic T cells, and that their immunogenicity depends on several of them being
tandemly repeated. These epitopes are present on the 105 amino acid synthetic peptide
and tandemly repeated 5 times. Immunization of mice with this peptide in soluble form
and with incomplete Freunds adjuvant generates a desired cellular immunity. This has
not been achieved previously with short synthetic peptides. The length of the peptide
which allows for the native structure to form, and the tandemly repeating epitopes
are novel characteristics of this molecule and may be responsible for its immunogenicity.
[0093] Although the cDNA sequence of the mucin gene was available, the use of a tandemly
repeated epitope for MHC-unrestricted stimulation of the immune response was not predictable.
It is a novel discovery that a structurally stable, tandemly repeated molecule, which
contains important immunogenic amino acid residues derived from any antigen (bacterial,
viral, tumor, autoantigen) will be capable of eliciting an immune response in all
individuals, independent of their HLA (MHC) molecules. Furthermore, the technique
for successfully synthesizing these long tandem repeat peptides is novel as well.
[0094] The mucin structure may be used as the prototype of such a structure. An example
is shown below:


[0095] The multiple prolines are necessary for maintaining the rigid structure, even though
their exact position may not have to be maintained. The sequence DTR in the mucin,
located between the first two prolines in each repeat, is the target of the anti-mucin
immune response. The rest of the sequence is inert for purposes of an immune response
and can be left unchanged to serve as scaffolding, which further maintains the three
dimensional structure. The DTR sequence can be substituted by a sequence from a virus,
tumor antigen or autoantigen.
[0096] In general, the substitution sequence is a short peptide (for instance, about 3 amino
acids long), in which only two or three amino acids are capable of contacting a T
cell receptor for recognition by the immune system. The short peptide may, for instance,
be derived from a long peptide bound to HLA.
[0097] Because most of these short amino acid sequences do not have a stable structure,
they must bind to an HLA molecule in order to be presented to the immune system. This
binding is very specific and depends on a specific type (allele) of an HLA molecule.
Thus when an immunogenic sequence is identified by its ability to stimulate immune
response in some individuals, there will be other individuals with different HLA types
such that their immune system will not be stimulated by it. This dependence on HLA
is known as HLA restriction and it is a problem which must be overcome in designing
peptide-based vaccines. The mucin-like structure bypasses HLA-restriction and the
need for peptide presentation by providing the necessary rigid, stable, and tandemly
repeated structure capable of activating T cell receptors, B cell receptors and the
immune system.
[0098] Multiple tandemly repeated mucin epitopes stimulate T-cells directly, independent
of presentation by patients' HLA molecules. The long synthetic mucin peptide containing
5 or more tandem repeats is designed to stimulate T cells directly. This is very significant,
as peptide vaccines are usually restricted in use by the HLA type of a patient and
its ability or inability to present the vaccine peptide. The long synthetic mucin
peptide can be used as a vaccine in all patients. Furthermore, any immunogenic sequence
superimposed on the mucin-like structure may be capable of stimulating an immune response
in all subjects regardless of the HLA type.
[0099] The principles established with the long synthetic mucin peptide regarding the ability
of tandemly repeated epitopes to stimulate immune responses independently of patients'
HLA types, can be applied to other epitopes found in tumor antigens, in viral antigens,
and in autoantigens. These epitopes are immunogenic only in a sub population of people
with a particular HLA type capable of presenting them. Synthesizing these epitopes
according to the mucin structure may render them independent of presentation by HLA
molecules, and immunogenic in all individuals. Thus, one advantage of using the peptides
of the present invention is their ability to induce a non-MHC-restricted immunogenic
response in mammals regardless of their HLA type.
[0100] For instance, synthetic mucin peptide composed of five tandem repeats and 5 amino
acids (such as, for instance, GVTSA, which may be placed on the back end or, preferably,
the front end of the peptide), 105 amino acids long, may substitute for the native
molecule as an immunogen. Thus, it is ideal for use as a synthetic vaccine. Synthetic
mucin 105 peptide represents a prototype of a stable tandem repeat structure, onto
which other immunogenic epitopes can be synthesized, and immune responses to them
made HLA-unrestricted.
[0101] These immunogenic conjugates would be suitable for immunization against the disease
whose antigenic epitope has been designed into the multiple tandem repeat synthetic
peptide when administered in an immunogenically effective amount to a mammal, for
example by the intradermal route.
[0102] Epitopes which can be incorporated into the multiple tandem repeat synthetic peptide
include, for instance, an antigenic epitope corresponding to a virus (for example,
HIV), a bacteria, or cancer (for example, pancreatic cancer, breast cancer, ovarian
cancer or colon cancer). (See Table 2.)
[0103] Vaccines of the instant invention, which, when administered to a mammal, induce a
protective immunogenic response against the epitope present on the repeats, comprise
one or more immunogenic mucin-like peptide, comprising a peptide with the disease-specific
epitope, wherein each disease-specific epitope corresponds to a different portion
of the epitope.
[0104] In addition, it is possible to produce a bivalent vaccine whereby immunogenic peptides
described above, comprising synthetic peptides from epitopes of two different diseases,
are mixed to form a single inoculum such that protective antibodies will be simultaneously
raised in a mammal to both diseases.
[0105] As discussed above, the synthetic method of the invention is novel in that it achieves
efficient and reliable synthesis of long peptides. There are a number of advantages
associated with peptides of long length over the shorter peptides currently being
synthesized. These advantages include, for instance,
(1) the formation of native structure,
(2) the inclusion of more sequence and structural information within the same molecule,
(3) the fact that larger peptides make better antigens,
(4) the ability to cross link the antigen receptors of both B and T antigen receptors
on the surface of immune system cells and directly induce either antibody production
or T cell activation, and
(5) the development of high avidity type interactions between a given peptide substrate
and multivalent antibodies (for diagnostic purposes).
[0106] With respect to the formation of native structure, the poly-reverse turn structure
of this peptide motif may enable the use of the peptide for the development of vaccines.
For a folded native protein, the backbone, which is composed of the linear sequence
of amino acids, the chain traverses the hydrophobic interior of the protein and turns
around at the surface using a reverse turn (or β-turn) to reverse the direction of
the protein chain. The important antigens of bacteria and viruses are proteins and
fold the same way, so a large portion of the surface of an antigen is composed of
these turns.
[0107] Consequently, during an infection, antibody molecules, which are on the surface of
B cells, first come into contact with the surface viral antigens, in their native
fold, which are reverse turns. Turn structures are the easiest types of secondary
structure to predict or to detect based on the sequence alone, without actually solving
the structure of the protein. These structures are typified by the presence of proline
and glycine. Many of the known neutralizing (protective) antibody binding sites of
many viral and bacterial antigens are known or are believed to be these turn structures.
[0108] For example, the primary neutralizing determinant of HIV-1(the V3 loop), the virus
that causes AIDS, contains the essential sequence GPGRAF. By all criteria of protein
secondary structure prediction and by experimental determination, this sequence forms
a reverse turn in the native protein. Antibodies to this structure are known to neutralize
HIV-1 and hence protect from the pathogenic effects of the virus. This sequence can
be substituted into the mucin sequence in the following way:

[0109] The synthetic production of these sequences in a repeating manner will produce a
mucin-like molecule with multiple copies of the V3 loop in what may be the native
turn structure. This peptide molecule may be used beneficially, such as in the following
applications.
[0110] It has been shown that mucin-like molecules can induce IgM antibodies. IgM antibodies
are pentavalent (5 copies joined together in a cylindrical manner) and therefore quite
large. Thus, these antibodies may be excellent neutralizing antibodies. The huge size
may be very effective in blocking the entry of the virus into the cell. Currently,
none of the known neutralizing antibodies to HIV-1 are IgM, because only polyvalent
antigens induce IgM.
[0111] Furthermore, IgM can be induced independently of T cells in an HLA unrestricted fashion.
This would be advantageous to AIDS patients who are T-cell depleted and/or T-cell
suppressed and are, therefore, unable to mount effective HLA restricted immune responses.
A large poly-valent V3 loop antigen could be a very effective immunotherapeutic agent
for HIV-positive people, and could significantly boost the immunity to the virus and
slow or prevent the onset of AIDS in these hopeless people.
[0112] Longer peptides are also advantageous in that more sequence and structural information
within the same molecule are included. For instance, additional sequences that code
for T-cell epitopes could be inserted into the proline rich backbone and tandemly
repeated to produce a mucin like molecule to induce antibodies in a T-cell dependent
fashion or HLA-restricted fashion.
[0113] In addition, longer peptides make better antigens than shorter peptides. Furthermore,
longer peptides exhibit the ability to cross link the antigen receptors of both B-
and T-antigen receptors on the surface of immune system cells, and directly induce
either antibody production or T-cell activation. Also, longer peptides would enable
the development of avidity type interactions between a given peptide substrate and
multivalent antibodies, which is useful in, for instance, diagnostic testing.
[0114] In addition to the use of these peptides as a vaccine, or as a component of a vaccine,
the peptides of the present invention can also be used for diagnostic purposes. The
presence and titers of antibodies to a specific disease in biological samples can
be detected using synthetic peptides designed with the specific epitope for an immunogenic
agent of the disease being measured.
[0115] Thus, in yet a further embodiment, the invention relates to a method of detecting
the presence of antibodies to a specific disease (for instance, cancer, HIV, autoantibodies)
in a biological test sample, comprising the steps of:
a) contacting the above-described synthetic muc-1 or muc-1-like peptide containing
an epitope with the biological test sample (such as, for instance, serum or plasma),
which epitope is reactive with antibodies to the disease, under conditions such that
a synthetic muc-1 or muc-1-like peptide-antibody complex is formed, and
b) detecting the formation of the synthetic muc-1 or muc-1-like peptide-antibody complex,
which complex is indicative of the presence of antibodies to the specific disease.
These peptides can be used, for example, in a standard enzyme-linked immunosorbant
assay (ELISA) or a radioimmunoassay (RIA) to detect the presence of antibody in biological
samples.
[0116] In addition, the peptides may be used as a diagnostic reagent to evaluate patients'
immune responses to their tumors pre- and post-immunization. For example, long synthetic
mucin peptides may be a useful indicator of an ongoing immune response in patients
with pancreatic, breast, ovarian, and colon cancers. The presence of anti-mucin antibody,
before and after immunization, cannot be detected with short peptides, but is easily
detectable when, for instance, the 105 amino acid peptide is used in ELISA. This peptide
may be useful even in unimmunized patients for measuring the low level but existing
immune response to the tumor. Thus, the peptide may be used for distinguishing between
patients who are already responding to their tumor, and those who are not, which may
significantly influence any decision regarding the course of treatment and prognosis
of the patient's disease.
[0117] In view of the foregoing and the state of the art, it will be clear to those of ordinary
skill in the art that disease specific test kits can be constructed for detecting
antibodies to the desired disease in biological samples using techniques for detection
that include ELISA, RIA, indirect immunofluorescence and Western blot analysis.
[0118] The agent may be a radioisotope (for example, Yttrium 90 and Iodine 131), chemical
(for example, methotrexate), toxin (for example, ricin or parts thereof), or enzyme.
[0119] One and two tandem repeats, (i.e., 20 or 40 amino acids) maintain stable secondary
structure and react well with specific monoclonal antibodies. In general, to stimulate
the production of antibodies, peptides having several tandem repeats which can cross-link
antigen receptors are required. However, since the shorter form maintains stable structure
but is incapable of cross-linking receptors and activating the immune system, it may
be used for blocking immune responses. This may be very important in autoimmunity
and in transplantation.
[0120] Synthetic mucin tandem repeat peptides of only 20 or 40 amino acids do not stimulate
immune responses because they cannot cross-link receptors. However, for purposes of
inhibiting or blocking immune responses, various antigens or targets of an undesired
immune response can be synthesized onto the mucin structure and used to block the
interaction of the immune response with its natural target.
[0121] Target antigens in autoimmunity are not known yet. However, techniques now exist
to begin to identify specific peptides involved in autoimmune responses. When these
peptides are identified, two-or three-amino acid residues will also be identified
that are specifically recognized by autoimmune T cells. These residues may be used
to replace DTR or some other amino acids in the mucin short tandem repeat peptide.
Because this peptide would be mucin-like, and thus structurally stable, it is expected
to bind directly to the T cell and B cell receptors and antibodies and block their
interaction with the target antigen.
[0122] An example of an autoimmune disease where this blocking strategy may be applied is
rheumatoid arthritis. Even though the target antigen is not known, there is a very
strong association of rheumatoid arthritis and the presence of HLA-Class II molecules
which share all of the amino acid sequences, three amino acids long. These sequences
are thought to be involved in presenting the antigen to T cells. By substituting the
mucin DTR sequence by one of these amino acid sequences on a short synthetic tandem
repeat peptide (20 or 40 amino acids) it may be possible to block autoimmune T cells.
[0123] All autoimmune diseases are characterized by the presence of autoantibodies. In many
instances the precise targets of these antibodies are known. These antibodies could
be prevented from binding to their targets with short mucin peptides carrying specific
epitopes recognized by the antibodies.
[0124] In the present invention, long tandem repeat peptides (for example, 105 amino acids
in length) are stimulatory because they not only bind but also cross-link receptors.
Short (for example, 20 or 40 amino acids in length) are expected to block or inhibit
an immune response because they bind but do not cross-link. In that way they can only
interfere with binding to the real target.
[0125] The target antigen in graft rejection is the HIA molecule itself. It may be possible
to use sequences which differ between the organ donor and the organ recipient HLA,
synthesize them on the mucin structure and use to block cells or antibodies rejecting
a transplanted organ.
[0126] The ability to synthesize long synthetic peptides with tandem repeat structure allowed
the inventors to test the first ever synthetic peptide vaccine in cancer patients
in a clinical trial which was conducted at the University of Pittsburgh. The vaccine
consisted of 100 g of the 105 amino acids long mucin synthetic peptide which contains
5 tandem repeats, mixed with BCG adjuvant. The vaccine was administered as three subcutaneous
injections, three weeks apart. The peptide was synthesized according to the above-described
procedures. The clinical protocol was designed and approved by the University of Pittsburgh
Institutional Review Board. The protocol was then submitted to the Food and Drug Administration,
which after examining the specificity, identity, toxicity and safety experiments performed
on the peptide, approved it as an investigational new drug (BB-IND 5114). Approval
was granted to initiate a phase I / phase II trial on 60 cancer patients with advanced
pancreatic, colon and breast cancers, who had failed all previous therapies. The trial
was designed to test for possible toxicity, and the potential of the peptide to modulate
immune response in vivo. In the sixty patients vaccinated so far no peptide related
toxicities were observed.
[0127] The most important parameter the inventors were trying to achieve and measure was
an increase in numbers of T cells capable of killing mucin expressing tumor cells.
In the first four patients who completed the vaccination protocol, the number of cytotoxic
T cells appeared to have doubled (Table 6).
[0128] As described above, long synthetic peptides can be used as diagnostic tools for detecting
specific immune responses. In the clinical trials, the inventors have used this feature
of a long tandemly repeated mucin peptide to detect anti-mucin, and therefore potentially
anti-tumor antibody responses in sera of cancer patients. This same feature of the
mucin peptide was used to measure pre- and post-vaccination antibody levels in vaccinated
patients. As expected, about 10% of patients showed detectable antibodies, and again
as expected from the design of the vaccine, the antibody response did not increase
after vaccination (Table 7). The vaccine was designed to increase T cell immunity
only.
[0129] An important observation in this initial trial was that the long mucin synthetic
peptide can be used to measure the state of preexisting immunity in cancer patients.
The inventors have performed skin tests by injecting 100 g of the 105mer peptide alone,
which would cause a reaction only if the same molecule has been previously seen by
the patient. Table 8 shows that virtually every patient responded to the peptide.
The response was measured by biopsying the site of injection and growing the infiltrating
T cells in vitro. This indicated that the same epitope previously seen on the patient's
tumor, was properly mimicked by the synthetic peptide to induce a recall response.
Fewer responses were observed against an equimolar mixture of short 9 amino acid mucin
peptides which contained the main immunogenic epitope, 9mer(+PDTRP), and fewer yet
to short peptides which excluded that epitope, 9mer(-PDTRP). Fewer responses are due
to the HLA dependence for recognition of short peptides, such that not all patients
can recognize them, only those which carry the correct HLA molecules. Of the 55 patients
included in Table 8, 11 were non-responders, which illustrates their general suppressed
state of immunity due to their disease. Tables 9, 10 and 11 give a more detailed evaluation
of the response for each patient who responded to one or more peptides.
[0130] Several important points can be drawn from these results:
1. From the skin test results it is clear that the long synthetic peptide indeed mimics
the native mucin molecule expressed on cancer cells. Patients immune system which
has previously encountered this molecule on the tumor recognizes a corresponding immunogenic
epitope on the synthetic peptide.
2. The inventors chose to first test the generation of immunity with the 105mer peptide
in a mixture with a potent adjuvant BCG. Having the skin test results confirming the
potential of the 105mer to be recognized by the immune system, several different forms
of the vaccine may be designed based on the long peptide. Other adjuvants may be used,
peptide concentration may be increased, the peptide may be administered in combination
with various cytokines, etc.
3. The inventors have shown that the peptide can be used as a diagnostic tool to detect
antimucin, and therefore anti-tumor immunity, both cellular (skin test), and humoral
(antibody in ELISA assays).
[0131] The inventors proposed to assess immune response to mucin expressed in breast, colon
and pancreatic tumors using the delayed type hypersensitivity (DTH) response to varied
pools of nonameric long mucin peptides in patients with breast, colon or pancreatic
carcinoma: 1) untreated patients, 2) patients completing therapy (post therapy) and
without apparent disease and 3) patients with advanced, metastatic disease. This protocol
was designed as a test of whether an immunologic response to pancreatic/breast/colon
mucin peptides exists
in vivo. In patients with pancreatic, colonic or breast malignancies, both antitumor or toxic
side effects may be observed in patients tested for DTH but this is felt to be very
unlikely. These will represent secondary goals of this protocol. Twenty patients with
untreatable or metastatic disease will be immunized thrice at three weekly intervals
and assessed for
in vivo and
in vitro immune reactivity.
[0132] Pancreatic, colonic and breast adenocarcinoma arise from malignant transformation
of normal ductal epithelial cells. Both normal and transformed ductal epithelial cells
express on their surface a large glycoprotein, mucin, which in normal cells is confined
to the apical surface facing the duct. A certain number of mucin molecules are cleaved
off the cell surface and can be found in ductal secretions. The directional expression
of this molecule is lost in the tumor, and so is the architectural constraint of the
normal duct, which results in the aberrant expression of mucin on the entire tumor
cell surface, as well as its abnormal presence in the peripheral blood circulation.
It thus becomes accessible to the immune system for recognition.
[0133] By characterizing cytotoxic specificity of T cell lines derived from pancreatic and
breast cancer patients, the inventors identified the mucin molecule as the tumor antigen
capable of stimulating patients' T cell immunity. The inventors further identified
a peptide epitope on this molecule PDTRP, previously defined with a breast tumor specific
monoclonal antibody, which serves as a target for tumor specific cytotoxic T cells
(CTL). Normal mucin producing cells do not express this epitope. The presence or absence
of this epitope correlates with the ability of mucin producing cells to be killed
by tumor specific CTL. It is now known that this is a linear epitope present on the
polypeptide core of the mucin, that it is cryptic on normal mucin, masked by glycosylation,
and uncovered on malignant mucins due to incomplete glycosylation. There are several
other peptide epitopes, detected by antibodies, which are preferentially expressed
on tumor mucins due to incomplete glycosylation.
[0134] The goals of the clinical trial were to use a synthetic mucin peptide carrying tandemly
repeated mucin epitopes as well as shorter peptides to evaluate the extent and frequency
of mucin specific immune responses in patients with breast and pancreatic tumors,
and the feasibility of inducing or intensifying these responses by injection of synthetic
mucin peptides. The study demonstrated a more efficient anti-mucin immune responses
which may lead to inhibition of tumor growth and prolonged survival.
[0135] Before developing any more complex immune stimulants such as recombinant vaccines,
cytokine containing preparations, or preparations combined with bacterial adjuvants
it was important to assess the presence (or absence) of detectable delayed type hypersensitivity
(DTH) responses to this molecule. The ability of a synthetic mucin peptide to function
as a vaccine was be tested as a vaccine in patients with otherwise untreatable colon
or pancreatic cancer.
MHC-restricted and unrestricted recognition of mucin by T cells.
[0136] Mucin-specific T cells derived from either breast cancer patients or pancreatic cancer
patients were capable of specific lysis of all tumors, but no other mucin producing
tumors or normal mucin producing cells. The identity in the polypeptide core sequence
of breast and pancreatic tumor mucins explained the unique specificity for those two
tumors. Differential reactivity of normal and tumor mucins with several tumor-specific
antibodies indicated differences in epitope expression which correlated with susceptibility
to CTL lysis.
[0137] The perfectly conserved tandem repeat structure provided an explanation for the apparently
MHC-unrestricted recognition of this molecule. MHC-unrestricted antigen specific activation
of T cells, although uncommon, is not unique to mucins, but rather it may be a property
of molecules and epitopes of certain defined characteristics. A T cell is activated
through its antigen receptor either by antigen or anti-receptor antibody. Activation
with anti-receptor antibody shows that receptor crosslinking is sufficient to activate
a T cell. Multiple engagements and crosslinking of the TCR are highly unlikely events
for most antigens. An efficient signal through a single receptor is thus delivered
though the trimolecular, TCR/antigen/MHC complex, but only when this complex is made
more stable by the accessory interactions of the CD4 and CD8 molecules with their
MHC ligands. Most antigens alone do not, under normal circumstances, bind to the TCR
with the sufficient affinity to activate a T cell. There are situations when this
can be expected and has been seen to occur: 1) when the density of the antigen on
the presenting cell is very high so that multiple T cell receptors can engage simultaneously,
and 2) when the antigen is sufficiently large with numerous identical antigenic epitopes
which can engage multiple receptors simultaneously. Mucin molecules fulfill both of
these requirements.
Tumor specific epitopes on mucin molecules.
[0138] In order for mucins to serve as potential tumor specific antigens it must be supposed
that mucins made by tumor cells are in some way distinct from mucin made by normal
cells. Unique reactivity of breast tumor specific CTL for tumor but not normal mucin
producing cells supports that possibility. It has been shown that the carbohydrate
side chains of the tumor-produced mucins are shorter than the side chains of mucins
produced by normal cells. There is also an indication that in tumor mucins not all
of the potential glycosylation sites are used. This results in unmasking of otherwise
cryptic protein core epitopes on tumor mucins which serve as tumor specific antigens.
The same epitopes are concealed in normal mucins by complete glycosylation (Girling
A, Bartkova J, Burchell J, et al. A core protein epitope of the polymorphic epithelial
mucin detected by the monoclonal antibody SM-3 is selectively exposed in a range of
primary carcinomas. Int. J. Cancer 43: 1072, 1989; Hanisch F-G, Uhlenbruck G, Peter-Katlinic
J, Egge H, Dabrowski J and Dabrowski U. Structures of neutral O-linked polylactosaminoglycans
on human skim milk mucins. J. Biol. Chem. 264: 872, 1989; Yan P-S, Ho SB, Itzkowitz
SH, Byrd JC, Siddiqui B and Kim YS. Expression of native and deglycosylated colon
cancer mucin antigens in normal and malignant epithelial tissues. Laboratory Investigation
62: 698, 1990).
[0139] The inventors have further explored the expression of tumor specific epitope as a
result of incomplete mucin glycosylation and have confirmed this phenomenon in a controlled
experimental setting. This phenomenon can now be reproducibly caused to occur. With
that in mind, non-glycosylated synthetic peptides were used to test the DTH reading
and to immunize, allowing for synthetic maximal exposure of immunogenic epitopes.
[0140] Experiments performed to date
in vitro provide evidence that patients with mucin producing adenocarcinomas have T cells
capable of reacting with the tumor, and provide information regarding the nature of
the tumor specific epitope(s) that can now be used as a basis for a rational vaccine
design. Details of these findings can be summarized as follows:
1. Breast or pancreatic tumor-specific T cells (CD4+ and CD8+) can be isolated from
regional lymph nodes of cancer patients and expanded to large numbers in vitro.
2. Both T cell populations react with epitopes on the mucin molecule.
3. One such epitope, the target for CTL activity, has been identified using an antibody
SM3 which blocks CTL function and is specific for linear sequence PDTRP of the mucin
20 amino acid polypeptide core tandem repeat PDTRPAPGSTAPPAGHVTSA.
4. This epitope appears tumor specific, inasmuch as the T cells and the SM3 antibody
do not recognize normal mucin producing cells.
5. Several other epitopes located on the polypeptide core are preferentially expressed
on the tumor mucins and not on normal mucins.
6. The reason for the preferential expression of these epitopes is the aberrant glycosylation
of the mucins in transformed cells.
7. Mucin CDNA expression vector drives high level of expression of mucin in EBV immortalized
B cells, but this mucin is more glycosylated lacking some (e.g.SM3) and expressing
lower levels of other tumor specific epitopes.
8. Inhibition of O-linked glycosylation in the transfected cells leads to the expression
of SM3 and increased expression of other tumor specific epitopes, and to the ability
of these cells to sustain specific proliferation of CTL and to be susceptible to CTL
lysis (Kufe D, Inghirami M, Abe D, Hayes H, Justi-Wheeler H and Schlom J. Differential
reactivity of a novel monoclonal antibody (DF3) with human malignant versus benign
tumors. Hybridoma 3: 223, 1984; Hilkens J, Buijs F, Hilgers J, et al. Monoclonal antibodies
against human milk-fat globule membranes detecting differentiation antigens of the
mammary gland and its tumors. Int. J. Cancer 34: 197, 1984; Burchell J, Gendler S
and Taylor-Papadimitriou J. Development and characterization of breast cancer reactive
monoclonal antibodies directed to the core protein of the human milk mucin. Cancer
res. 47: 5476, 1987).
[0141] The ability to dissect the precise immunogenic epitopes recognized by T-cells on
other disease sites has only recently been possible (Hart MK, Weinhold KJ, Scearce
RM et al. Priming of anti-human immunodeficiency virus (HIV) CD8+ cytotoxic T cells
in vivo by carrier-free HIV synthetic peptides. Proc. Natl. Acad. Sci 88: 9448-9452, 1991;
Kast WM, Roux L, Curren J, et al. Protection against lethal Sendai virus infection
by
in vivo priming of virus-specific cytotoxic T. lymphocytes with a free synthetic pentide.
Proc. Natl. Acad. Sci. 88:2283-2287, 1991; Battegay M, Oehen S, Schulz M, Hengartner
H, and Zinkernagel RM. Vaccination with a synthetic peptide modulates lymphocytic
choriomeningitis virus-mediated immunopathology. J. Virol. 66:119-1201, 1992). This
information has however been quickly applied in murine models in the 1991-1992 time
frame to allow priming
and protection in various viral disorders such as Sendai virus and lymphocytic choriomeningitis
virus infections using short peptides as vaccines. The studies undertaken and described
herein represented the first instance in which such approaches will be tested in humans
and in cancer.
Immunogenicity of a long synthetic mucin peptide.
[0142] The inventors synthesized a mucin peptide which consists of five complete 20 amino
acid tandem repeats plus 5 amino acids of the sixth repeat. In total this peptide
contains six tandemly repeated T cell-stimulatory epitopes. Using NMR analysis and
other biophysical measurements we have determined that this peptide assumes a native
mucin structure capable of reacting with anti-mucin antibodies with a much higher
avidity than a short peptide, and of stimulating T cell proliferation in vitro.
[0143] This long peptide was used to immunize Balb/C mice. 100 g of soluble peptide was
administered intraperitoneally, mixed with incomplete Freunds adjuvant. The mice were
boosted twice, at three week intervals. Seven days following the last boost the mice
were tested for DTH by a footpad injection of 20 g of soluble peptide. A long synthetic
peptide unrelated to mucin was injected into the contralateral footpad as control.
Additional controls were unimmunized mice. The swelling of the footpad was measured
at 24, 48, 72 hours. The mice were also bled and anti-mucin antibody measured in the
serum. DTH was observed in all mice previously immunized with the 105 amino acid peptide.
Relatively low levels of antibody were detected, and mostly of the IgM isotype.
[0144] Mice immunized with a shorter, 20 amino acid long peptide containing only one repeat,
and only one epitope, did not develop any immunity, and no DTH was observed even when
tested with the 105 amino acid peptide.
[0145] The ability of this long synthetic peptide to elicit an immune response in soluble
unconjugated form is very impressive. Even more impressive is its ability to preferentially
induce cellular immunity over humoral immunity. Peptides conjugated to very immunogenic
complex carrier proteins usually generate very high antibody level. The ability of
both antibodies and CTL to recognize the same epitope suggests a possibility that
antibodies, especially if produced preferentially and in larger amounts than specific
T cells, could block the T cell reactivity against the tumors.

[0146] The following non-limiting examples illustrate the invention in more detail:
EXAMPLES
[0147] The following materials, methods and protocols were used in the examples below.
Peptide Synthesis.
[0148] Peptides were synthesized using manual methods on a Rapid Multiple Peptide Synthesizer
(RaMPS) purchased from Dupont (Boston, MA). The syntheses were performed using 0.1
mM Rapid Amide (2,3-dimethoxybenzhydrylamine) resin cartridges purchased from Dupont
(Boston, MA). The solvents N,N-dimethyl formamide (DMF) protein sequencing grade,
methylene chloride (DCM) certified A.C.S. grade, and methanol Karl Fischer grade were
purchased from Fischer Scientific (Fair Lawn, NJ). The deprotection reagents of anhydrous
piperidine and trifluoroacetic acid protein sequencing grade, were purchased Sigma
(St. Louis, MO). The scavengers 1,2-ethanedithiol, thioanisole, and anisole were purchased
from Dupont (Boston, MA).
[0149] The Fmoc amino acid side chain protecting groups were tert-butyl esters (OtBu) for
aspartic and glutamic acid; tert-butyl ethers for serine, threonine, and tyrosine;
2,2,5,7,8-pentamethylchroman-6-sulfonyl (Pmc) for arginine; tertButyloxycarbonyl (Boc)
for lysine; triphenylmethyl (trt) for histidine; and all Fmoc amino acids were purchased
from Advanced Chem Tech (Louisville, KY). The amino acids were coupled as symmetric
anhydrides for alanine, arginine, and histidine; active esters of pentafluorophenol
for asparagine, aspartic acid, glutamic acid, glutamine, glycine, isoleucine, leucine,
lysine, methionine, phenylalanine, proline, tryptophan, tyrosine, and valine (OPfp);
active esters of 3-hydroxy-2,3-. dihydro-4-oxo-benzotriazine (ODhbt) for serine and
threonine; active esters of 1-hydroxybenzotriazole (HOBt) for histidine. The coupling
times were a standard one hour at room temperature using .25 mmo OPfp and ODhbt activated
amino amino acids and 0.1 mmo1 of HOBt in three ml DMF. Coupling reactions using .25
mmo1 of HOBt or symmetric anhydride activated amino acids were performed in 2 ml DMF
and 1 ml DCM for one hour at room temperature. The peptide resins were split in half
after a chain length of 30 amino acids was reached but the concentration of input
amino acid for the newly separated fractions was maintained at .25 mmo1 per 3 ml of
solvent. Ninhydrin reactions were performed at the completion of each coupling reaction
using ninhydrin test kit reagents purchased from Dupont (Boston, MA).
[0150] The Fmoc Nα protecting group is removed at the completion of a synthetic cycle by
shaking for 20 minutes in 3 ml 50:50 piperidine:DMF, followed by extensive washing
with DMF and methanol. The side chain protecting groups and cleavage of the peptides
from the resins were performed by shaking in 3 ml of 90:5:3:2, TFA: thioanisole: 1,2-ethanedithiol:
anisole for 4 hours at room temperature in 5 ml poly-propylene Quik-Sep disposable
chromatography columns from Isolab (Ackron, OH). The TFA and
peptide mixture was drained from the column into cold ethyl ether, followed by three
sequential extractions with ethyl ether, three extractions with 60: 40 ethyl ether:
ethyl acetate. Finally, the peptide is extracted into 3 ml of water and lyophilized.
Pentide Purification.
[0151] The crude peptide mixtures were purified by analytical reverse phase high pressure
liquid chromatography (RP-HPLC) on a Waters 600E chromatograph, with a Waters 486
absorbance detector (Milford, MA) and a Linear 1200 series recorder from Cole Palmer
(Chicago, IL). Analytical separations utilized a Delta Pak C18, 300 Å (3.9 X 300)
mm RP-HPLC column and semi-preparative separations used a uBondaPak C18, (7.8 X 300)
mm column from Waters (Milford, IL). Chromatography solvents were HPLC grade acetonitrile
from Fisher Scientific (Fair Lawn, NJ) and water both containing 0.1% TFA. The chromatographic
separations were performed using a 1% per minute linear gradient of water (0.1% TFA)
and acetonitrile (0.1% TFA). Initial conditions were 95:5. water: acetonitrile and
final conditions were 40:60, water: acetonitrile.
Mass Spectrometry.
[0152] Electrospray ionization mass spectra were obtained using a Vestec electrospray source
and model 201 single quadruple mass spectrometer (Vestec Corp., Houston, TX) fitted
with a 2000 m/z range (1,2). Samples were delivered to the source in a 10 microliter
injection loop at 5 microliters/min in 4% acetic acid: 50% acetonitrile.
Circular Dichroism.
[0153] The circular dichroism spectra were recorded on a Japan Spectroscopic Company (Jasco)
model J-710 circular dichroism spectropolarimeter (Hachioji City, Japan). The temperature
was controlled using a Jasco PTC-343 peltier-type thermostatic cell holder and temperature
control program. The spectrum was recorded from 195-260 nm with readings every 0.1
nm at 25, 55, 75, and 90°C. The peptide concentration was 0.1 mg/ml of HPLC purified
peptide in 0.01 M phosphate buffer at pH 7.2 except for the peptide H2D8 which was
used at 1.0 mg/ml in 20:80, acetonitrile:phosphate buffer (.01M pH 7.2). A 0.1-cm
path length strain free quartz cuvette was used to record the spectrum. The solvent
spectrum was subtracted from that of sample and a noise reduction subroutine was applied
to the resultant spectrum. A total of ten scans were accumulated for each sample.
No change in the solvent spectrum was observed with increasing temperature.
1H-NMR Spectroscopy of TR Peptides.
[0154] 1H-NMR analyses was performed using HPLC purified and lyophilized peptides. The concentrations
used were from 6-7.5 mM in 0.1 M phosphate buffer, pH 5.9 with either H
2O/D
2O (90%/10%) or D
2O (99.9%). We chose to use a high ionic strength buffer to reduce the electrostatic
interactions between molecules. A pH of 5.9 was chosen for the D
2O studies to avoid perturbations of the spectra resulting from the partial protonation
of histidine, but significantly different from the pKa value of histidine. The 1-dimensional
1H-NMR experiments in H
2O were performed at pH 6.8.
[0155] A Bruker AM-500 NMR spectrometer equipped with Aspect 3000 computer and a 5-mm
1H probe was used to record the spectra of the mucin muc-1 peptides. The spectra were
recorded at 25°C, with the temperature of the probe regulated with a BVT-1000 unit
and calibrated with a methanol sample. The D
2O spectra of the peptides were recorded 5 to 10 minutes after dissolution. Suppression
of the water signal was accomplished during the repetition delay of 1.5 seconds for
peptide samples in D
2O and H
2O. The one-dimensional spectra were recorded following a single 90° pulse. A control
spectrum of the H
2O sample was taken without water presaturation to ensure that none of the amide protons
were affected by presaturation of water signal at any given power level. A total of
1024 transients were collected for each spectrum. The two-dimensional correlated spectra
(COSY) was recorded in a phase sensitive mode. A sine bell filter was applied to the
time domain data in both F1 and F2. The acquired data size was 2048 x 1024 points.
Zero filling was used to obtained a final data matrix of 4096 x 4096 points. All proton
chemical shifts were relative to the reference compound 2,2-dimethyl-2-silapentane-5-sulfonate
(DSS) at 0.0 ppm.
Intrinsic Viscosity.
[0156] All viscometry measurements were performed using a Cannon-Fenske-Ostwald type capillary
viscometer with HPLC purified peptide in 0.1 M phosphate buffer at pH 7.0 and 30°C.
The procedure was as described previously (Tanford, et al., J. Am. Chem., 89:729-736,
1967 and Buzzell, et al., J. Phys. Chem. 60:1204-1207, 1956). The capillary constant
was as calculated as reported by Tanford and Buzzell, 1956 (Tanford, et al., J. Phys.
Chem. 60: 225-231, 1956). The kinematic viscosity measurements were repeated at least
ten times, and the averages were used to calculate the intrinsic viscosity. Intrinsic
viscosity was calculated from kinematic viscosity, and the appropriate density correction
(0.0029ml/g) was applied as recommended (Tanford, 1955). The Simha shape factor and
the peptide axial ratios were calculated according to (Tanford, 1961 and Cantor, et
al., 1980).
Molecular Modeling of the 60 Amino Acid Peptide.
[0157] The sequence of the tandem repeat (TR) domain of the human mucin muc-1 (Gendler,
et al., PNAS USA, 84: 6060-6054, 1987) gene was modeled into a polytype I turn conformation
on a silicon graphics model INDIGO (Mountain View, CA) terminal using the Tripos molecular
graphics program Sybyl (St. Louis, MO). Using this model the longitudinal axis and
cross sectional axis were measured, and the axial ratio (longitudinal/cross sectional)
of the 60 amino acid peptide was estimated (Table III).
[0158] The TR domains of human mucins muc-1,2,3,4 were also modeled according to the rules
of Chou and Fasman (1978) (Chou, et al., Ann. Rev. Biochem., 47: 251-276, 1978) for
secondary structure prediction. Surface potential was predicted using the "Surface
Plot" algorithm as described (Parker, et al., Biochemistry, 25: 5425-5431, 1986).
Potential amphipathic alpha-helical regions were predicted using the "Amphi" algorithm
of Margalit et al. (Margalit, et al., J. Immunol., 138: 2213-2229, 1987). The results
of these analyses were used to construct conformational models (results not shown).
The number of predicted turns per repeat is summarized in Table I.
EXAMPLE 1
Peptide Synthesis.
[0159] Sequences of peptides which were synthesized by RaMPS are shown in table 4. The naturally
occurring mucin tandem repeat is shown in table 4, number 1. The entire proline rich
neutralization domain of Feline leukemia virus and a 42 amino acid N-terminal fragment
of this domain is shown in table 4, No. 2, and 3, respectively. The T-cell epitopes
that were used to construct the engineered tandem repeat proteins and shown in table
4, No. 4, and 5 respectively.
[0160] Using the human mucin muc-1 tandem repeat sequence as indicated in Table 4 we synthesized
a series of peptides consisting of 1, 2, 3, 4, and 5.25 complete tandem repeats by
manual solid phase peptide synthesis as described above. Figure 8a shows the HPLC
profile of the crude peptide products from the synthesis of the 105 amino acid mucin
peptide. The electrospray mass spectrum (EMS) of the major fraction showing the correct
molecular weight of 9770 daltons is shown below (Figure 8e). The HPLC profile obtained
with the 105 amino acid mucin peptide and the EMS are representative of the profiles
from the syntheses of the 20, 40, 60,and 80 acid peptides corresponding to 1,2, 3,
and 4 tandem repeats of the human mucin muc-1 protein core. They all exhibited extraordinary
efficiency and fidelity of synthesis. The expected molecular weight was obtained for
each of the mucin peptide syntheses as shown in Table 5. Upon semi-preparative purification
of the mucin peptides 85-92% recovery final product were typically obtained.
[0161] The synthesis of the entire 60 amino acid proline-rich domain of the feline leukemia
virus external surface unit gp-70E (FeLV-PBH60) was also attempted by RaMPS. Figure
8b shows the analytical HPLC profile of the crude synthetic products from this manual
synthesis. The EMS of the major fraction (Figure 8f) and Table 5 shows that the correct
molecular weight was obtained. A related peptide (PRN42) corresponding to the N-terminal
42 amino acids of PRN60 (see Table 4) was also synthesized correctly as indicated
by the molecular weight of the major fraction (Table 5). All other peptides that correspond
to smaller analogs of PRN60 were synthesized with equal efficiency and fidelity.
[0162] Next was synthesized a peptide corresponding to a tandemly repeated nine amino acid
T-cell epitope from the cytomegalovirus pp89 sequence early regulatory protein (H2D8)
shown in Table 4. This peptide was previously identified as the optimal immunogenic
CTL epitope in H-2D
d mice (Reddehase, et al. Nature, 337: 651-653, 1992; Boyd, et al., PNAs USA, 89: 2242-2246,
1992). This peptide was selected because it contains two proline separated by three
amino acids as found in the major immunodominant B and T cell epitope (PDTRP) of the
mucin tandem repeat (Barnd et al., PNAS USA, 86: 7159-7163, 1989; Jerome et al., Cancer
Res. 51: 2908-2916, 1991). This peptide contains two proline residues per nine amino
acids and is 22 % proline. The HPLC profile of the crude synthetic 72 amino acid (H2D8)
peptide containing eight tandem repeats is shown in Figure 8c. The H2D8 peptide differs
greatly from the mucin and FeLV peptides in hydrophobicity. The EMS results of the
major HPLC fraction demonstrate that the correct peptide was obtained (Figure 8g).
A peptide corresponding to 5 tandem repeats showed similar results (Table 5).
[0163] In order to reduce the hydrophobicity of H2D8 a serine was added to position 10 in
the sequence and phenylalanine 4 was substituted to alanine to create H2Dmuc7. This
peptide was synthesized through seven tandem repeats (Table 4). These modifications
in H2Dmuc7 were shown to result in a peptide with markedly reduced hydrophobicity
as demonstrated by the HPLC profile of the 70 amino acid (Figure 8d). The EMS spectra
of the primary fraction shows that the correct peptide was obtained (Figure 8h).
[0164] To investigate the possibility that the resulting peptide conformation can be correlated
with the ease of synthesis, circular dichroism spectroscopy was performed on the HPLC
purified peptides. The CD spectrum of the mucin 105 amino acid peptide is shown in
Figure 9a. The large negative peak at 198nm is characteristic of proline rich proteins
known to form extended structures including bovine elastin (Urry, J. Prot. Chem.,
7: 1-34, 1987), C hordein (Tatham et al., Biochem. J., 226: 557-562, 1985), and collagen
and poly-proline II (Madison and Schellman, Biopolymers, 9:511-567, 1970b). The spectrum
observed with feline leukemia virus PRN60 (Figure 9b) is identical with that obtained
for mucin. Due to hydrophobicity (H2D8) was not soluble in .01 M phosphate buffer
at pH 7.2 and the spectrum of the tandemly repeated T-cell epitope peptide was acquired
in 20:80, acetonitrile: phosphate buffer. The spectrum consists of a large negative
peak at 222 nm and a smaller negative band at 238 nm. The CD spectrum of the modified
H2D8 peptide (H2Dmuc7) was acquired in phosphate buffer and is shown in Figure 9d.
This spectrum is similar to that obtained for mucin and PRN60 with a large negative
CD band at 198 nm.
[0165] The large negative CD band at 198nm is identical with that obtained for the model
proline compound N-acetyl-L-proline-N,N-dimethylamide (AcProDMA) (Madison and Schellman,
Biopolymers, 9:511-588, 1970 b & c). The large negative CD band at 198 nm for AcProDMA
in aqueous solution was shown to be due to three π-π* transitions and a large n-π*
transition in the tertiary amide and was shown to be characteristic of proline in
the trans conformation (Madison and Schellman, Biopolymer, 9:511-588, 1970 b & c).
The CD spectrum of AcProDMA in the
cis conformation is favored in hydrophobic environments and results in a positive band
at 198 nm and the resultant spectrum of a mixture of
cis and
trans isomers could be represented by a linear combination of the two spectra (Madison
and Schellman, Biopolymers, 9:65-94, 511-567, 1970 a & b).
[0166] To see whether the negative CD band at 198 nm is due to
cis and
trans proline isomers or conformational effects, the inventors tested the possibility that
increasing the temperature would decrease the CD intensity at 198 nm. The CD spectra
were recorded at 25, 55, 75, and 90 °C. Figure 8a, b, and d show that the CD intensity
at 198 nm in 0.01M phosphate buffer at pH7.2 was decreased at 90°C as compared to
25°C by 33% for mucin 105, 29% for PRN60, and by 22% for H2Dmuc7. In contrast, the
CD intensity of the shoulder region from 215 to about 240 nm increases for all the
peptides with increasing temperature. The set of temperature curves for mucin, PRN60,
and H2Dmuc7 exhibit isocircular dichroic points at 208, 209, and 207 nm (Figure 9a,
b, and d). This suggests the existence of two discreet populations, one at high and
one at low temperatures (Tatham et al., Biochem, J., 226: 557-562, 1984). The CD spectrum
of H2D8 (Figure 9c) was recorded at 10 fold higher concentration and was devoid of
the large negative peak at 198 nm. This suggests that in 20% acetonitrile this peptide
contains proline in the
cis conformation. The remainder of the spectrum of H2D8 from behaved like the shoulder
region of mucin, PRN60 and H2Dmuc7 with increasing temperature.
[0167] Figure 10 shows a plot of the molar ellipticity [θ] at 25°C for the mucin 20, 60
and 105 amino acid peptides, PRN60, H2Dmuc7 and a ten amino acid control peptide (TAENAEYLRV)
that does not contain proline. Clearly, the proline rich peptides exhibit dramatically
greater [θ] indicating the formation of secondary structure (Figure 10). The ratio
of [θ] of the proline rich peptides to [θ] of the control peptide at 25°C ranges from
3.2 for the mucin 20 amino acid peptide to 21.1 for the mucin 105 amino acid peptide.
These enhanced [θ] with increasing numbers of mucin tandem repeats correlates with
the formation of native secondary structure as detected by
1H-NMR spectroscopy and monoclonal antibody binding data (Fontenot et al., in press
1993A).
EXAMPLE 2
Monoclonal antibodies to native muc-1 recognized the synthetic peptides.
[0168] Monoclonal antibodies may be obtained by methods well known in the art. For instance,
antibodies may be obtained by immunizing mice with human tumor cells which express
mucin, or with purified human mucin which was or was not stripped of sugars. Monoclonal
antibodies were produced by standard Kohler Milstein hybridoma technology.
[0169] To verify that synthetic peptides corresponding to one-, two-, and three-tandem repeats
of muc-1 protein core fold into the native structure, the peptides were reacted with
a panel of muc-1 specific monoclonal antibodies (Table 2). These antibodies were previously
shown to react with epitopes specific for the carcinoma associated form of muc-1 (Taylor-Papadimitriou,
Int. J. Cancer, 49:1-5, 1991 and Jerome, et al., Cancer Res., 52:5985-5990, 1992).
The antibodies were reacted against equal quantities of the synthetic peptides in
a solid-phase ELISA. The reactivity is defined as the slope of the color change with
time.
[0170] Most antibodies failed to react with a twenty amino acid peptide corresponding to
one repeat and beginning with proline 1 (Table 2). However, these antibodies reacted
with peptides corresponding to two- and three-tandem repeats of the protein core.
A probable explanation for this is that native presentation of the predominant epitope
(PDTRP) recognized by these antibodies requires at least the alanine of the previous
repeat. This observation could explain the results obtained by others showing that
other amino acids can be substituted for alanine, and that peptides linked to a carrier
or a pin will react without alanine (Price, et al., Molecular Immunology, 27:795-802,
1990 and Xing, et al., Immunology, 72, 1991). The increase in reactivity of the monoclonal
antibodies with the 40 and 60 amino acid peptides indicates that the epitopes attain
a native conformation in the absence of glycosylation, reflecting the structure seen
in native mucin.
EXAMPLE 3
Mucin protein core formed a stable folded secondary Mtructure.
[0171] A finger print region of the two-dimensional correlated spectroscopy (COSY) of the
mucin 60 amino acid peptide in D
2O (Figure 2) clearly shows cross peaks of some nonexchangeable amide protons. This
particular region of the spectrum shows scalar correlation between amide-
1H and
1H-alpha protons. These cross peaks did not exchange during the duration of more than
12 hours at 27°C. Thus, these amide protons appear to be protected very well inside
the 3-dimensional structure of the folded mucin. This experiment clearly shows that
a mucin 60 amino acid peptide retains a stable ordered structure in solution, in distinct
contrast to the random coil conformation previously reported (Jentoft, Trends Biochem.
Sci., 15: 291-294, 1990).
EXAMPLE 4
Development of structure requires multiple tandem repeats.
[0172] Figure 3 shows the region of the
1H-NMR spectrum which is characteristic of β-protons of the amino acid side chains.
The nuc-1 tandem repeat sequence contains only one aspartic acid (D) and one histidine
(H) residue per TR, and the side chain, β-protons of these an amino acids are resolved
into two distinct regions of the spectrum (Wuthrich, NMR of proteins and mucleic acids,
John Wiley and Sons, New York, N.Y., 1986). Figure 3 shows the spectrum of the free
amino acids as compared to the spectrum of the synthetic peptide corresponding to
one-tandem repeat, two-tandem repeat, and three-tandem repeat peptides. Arrows indicate
differences in the spectra associated with increasing numbers of tandem repeats in
the peptide. These spectra indicate that the development of an ordered structure depends
on the number of tandem repeats (size) in the peptide. If the secondary structure
of these peptides were random coil, the spectrum in this region would be expected
to be independent of the number of repeats present and to correspond closely to that
of the free amino acids (Wuthrich, NMR of proteins and mucleic acids, John Wiley and
Sons, New York, N.Y., 1986). The data in Figure 3 show clearly that the spectrum is
dependent on the number of repeats and is significantly different from the spectra
observed for free amino acids.
[0173] Free amino acids, or peptides containing one, two or three 20 amino acid repeats
of nuc-1 core all contain the same information when considering the
1HNMR responsive protons in the region of the spectrum from 1.6 to 3.3 ppm from DSS
(Wuthrich, NMR of proteins and mucleic acids, John Wiley and Sons, New York, N.Y.,).
Differing chemical shifts and numbers of peaks are the result of changes in the local
magnetic fields arising from structural changes (folding) of the peptide backbone.
Of particular interest in Figure 3 are the distinct spectral changes occurring in
the aspartic acid, β-proton resonances (2.4 to 2.7 ppm) when going from free amino
acids to one-, two-, and three-tandem repeats. Similarly, structural changes are evident
from the changes in the histidine β-proton resonances (2.9 to 3.3 ppm) as the number
of protein tandem repeats increases. These results can be interpreted to indicate
that an ordered structure is not completely formed in a peptide with only one 20 amino
acid repeat, and that the larger peptides containing 2 and 3 tandem repeats contains
sufficient folding information to result in a cooperative formation structure.
EXAMPLE 5
Intrinsic viscosity measurements support a folded rod-shaped structure.
[0174] The intrinsic viscosity [η] ml/g is a sensitive measure of the state of folding,
and the molecular shape (globular vs. rod-like) of a protein (Tanford, Physical Chemistry
of Macromolecules, John Wiley and Sons, New York, N.Y., pp. 798-799, 1961 and Tanford,
et al., 1967). Tanford has shown that for a protein in a random coil state, the intrinsic
viscosity [η] ml/g is at a maximum and is given by the equation [η] ml/g= .684 n
0.67 where n is the number of amino acids in the protein. The random coil intrinsic viscosity
of a protein depends only on the number of residues. For a 60 amino acid peptide the
intrinsic viscosity value is predicted to be 10.7 ml/g. The measured value for the
muc-1 synthetic peptide with 3 repeats is 7.71 ml/g (Table 3). This value of 7.71
ml/g would correspond to the expected intrinsic viscosity of a random coil 36 amino
acid peptide. The measured value of intrinsic viscosity for the muc-1 peptide with
3 repeats is significantly less than expected if the peptide were random coil. Therefore,
based on intrinsic viscosity, this peptide assumes an ordered conformation in solution,
in agreement with the structure suggested by previous NMR experiments.
[0175] Intrinsic viscosity can also yield information about molecular shape. The intrinsic
viscosity for all globular proteins is 3.3 to 3.9 ml/g and is independent of molecular
weight (Tanford, Physical Chemistry of Macromolecules, John Wiley and Sons, New York,
N.Y., pp. 798-799, 1961). The value of 7.71 ml/g for the nuc-1 peptide with 3 repeats
rules out a globular shape and is consistent with a rod-like shape with an axial ratio
(length/width) of 9.2 (Cantor, et al., Biophysical Chemistry Part 2: Techniques for
the Study of Biological Structure and Functions, W.H. Freeman and Co., New York, N.Y.,
1980). This measured axial ratio value (9.2) is in agreement with the value of 9.7
determined from the molecular graphics program
Sybyl in which the peptide sequence was modeled as series of type I reverse turns (Table
3).
[0176] It can be concluded from the intrinsic viscosity value that the peptide with 3 repeats
forms an ordered conformation in solution that is rod-like in shape with a longitudinal
span of 33-34 A/repeat. This result suggests that the unglycosylated protein core
could determine the extended structure seen in electron micrographs (Lan, et al.,
J. Biol. Chem., 262: 12863-12870, 1987). These results also support the hypothesis
that the muc-1 protein core exists as a poly-proline β-turn helix.
EXAMPLE 6
Model of a poly-proline β-turn helix for muc-1 TR domain.
[0177] Figure 7 shows a computer model of the sixty amino acid peptide in the poly-proline
β-turn helix conformation that was created by assuming that the mucin sequence exists
in a poly-type I turn conformation. This model reveals that the amino acid side chains
radiate outward from an extended rod-like backbone, and are completely exposed to
the solvent (Figure 7). This orientation of the side chains facilitates accessibility
of potential glycosylation sites to the glycosylation machinery. The secondary structure
is not necessarily dependent on glycosylation, nor does it have to be disrupted by
the addition of carbohydrate. This model explains . the lack of effect that heating
the peptides has on the NMR spectrum. Since no unfolding can occur in the globular
sense with side chains moving from a buried hydrophobic core to an aqueous exterior,
there are no large chemical shifts of the side-chain protons upon heating (Price,
et al., Molecular Immunology, 27: 795-802, 1990). The model also explains why the
A and DT residues will permit substitution within the primary epitope of APDTRP. When
the turn is formed, the P and R amino acid side chains are in the same space and accessible
for binding to the antibody. Substitutions that allow the turn to form will be tolerated.
EXAMPLE 7
Clinical trials.
Ethical Considerations
[0178] Since no "vaccination" was to be performed in patients without metastatic disease
but rather a simple detection of DTH to carrier free, adjuvant free mucin peptides,
it was anticipated that no or little toxicity will be incurred. Although no direct
patient benefit may be accrued in these patients, such studies serve as the basis
for immunotherapies which could benefit these or subsequent patients. Thirty patients
(Group 3) with untreatable pancreatic, colon or breast carcinoma will receive a vaccine
utilizing these peptides and adjuvant.
Schema
[0179] Patients stratified by group: (Pancreatic (P) Breast Cancer (B), colon cancer (C)
Group 1. Untreated patients (1OP, 1OB, 1OC)
Group 2. Post-treatment group (1OP,1OB, 1OC)
Group 3. Advanced, metastatic group (60 pts: stratified as eligible patients present
for treatment)
- PBL harvest for test of T cell reactivity to mucin; and HLA typing
- Immunohistochemistry of primary tumor for presence of antibody defined inmunoractive
mucin.
- Serum tested for presence of circulating mucin or antibody to it (ELISA)
- Three separate formulations were used to test immune reactivity. The first encompassed
eight separate nonameric sequences consisting of the amino acids 1-9,2-10,3-11, 15-23,16-24,18-26,20-28,
and constituted peptides containing at least three of the five amino acids felt to
be the likely immunogenic epitope based on prior serologic and cellular reactivity.
The second preparation encompassed the other seven nonameric sequences. The third
preparation consisted of a synthetic 105 amino acid polypeptide spanning 6 conserved
tandem repeat observed in the mucin molecule.
- Graded (1,10,100,ug) skin test to individual nine amino acid peptide pools (Preparation
1;PDTRP predominant, Preparation 2-other peptides (6-14, 7-15,8-16,9-17, 10-18, 11-19,
12-20, 14-22) and Preparation 3: 105 amino acid polypeptide (1-105).
- Concurrent multitest (Merieux) for reactivity to common recall antigens.
- Measure skin test for erythema and induration at 24 and 48 hours.
- Skin punch biopsy of highest antigen dose sites: 1) immunopathology, 2) in situ cytokine gene expression 3) T cell culture 4) PCR for cytokines and Va and VS usage.
- Repeat DTH testing at 3-8 weeks with two peptides with highest in vitro reactivity and a peptide with no in vitro reactivity, controlled with response to the 105 aa peptide in reactive patients.
Some patients may have each of the eight peptides in a group tested individually if
no in vitro tests are suggestive of peptide predominant reactivity.
- Daily vital signs, amylase, lipase, BUN/Creatinine during DTH testing (0,24, and 48
hours) and at 1-4 weeks post testing.
- Vaccination of group 3 patients at week 3, 6, and 9 with 100 ug of the long peptide
and BCG (5 x 107 TICE BCG, Organon Teknika Corp.; Chicago, IL.); repeated DTH testing
on three different peptide preparations at 12 weeks and assessed extent of disease.
Patient Selection
[0180] For the purposes of this evaluation patients were identified within the clinics and
hospitals of the University of Pittsburgh Medical Center, primarily within facilities
of the Pittsburgh Cancer Institute. Patients were either counseled by the examining
and participating physician following discussion with the principal investigators
or alternatively by referring the patient for initial "screening" by the protocol
nurse. Following evaluation and meeting the criteria noted below, patients had the
DTH tests applied and read in a blinded fashion. All patients, clinical results, X-rays,
and immunologic assays were presented in an ongoing fashion at meetings held every
weekly in the PCI outpatient clinic.
Eligibility Criteria
[0181] For DTH testing, patients must have had pancreatic, breast or colon carcinoma histologically.
proven. For immunization (Group C) patients must have had metastatic unresectable
or locally recurrent disease for which no other conventional form of therapy offers
a significant hope of cure or palliation.
[0182] Biopsy proven pancreatic, colonic or breast carcinoma.
[0183] Patients may have received chemotherapy prior to DTH testing. At least four weeks
must have elapsed since chemotherapy.
[0184] Patients may have received prior radiotherapy provided that at least four weeks have
elapsed.
[0185] A performance status of 0-2 (Zubrod) with life expectancy of at least three months.
[0186] Patients were at least 18 years of age.
[0187] Patients had at the start of treatment: WBC greater than 3,500 mm3, platelet count
greater than 100,000 mm3, serum creatinine less than 1.5 mg/dl or a creatinine clearance
greater than 60 cc/min., serum bilirubin less than 1.5 mg/dl.
[0188] Patients must have recovered from the effects of major surgery and must be free of
infection.
[0189] Written informed consent must have been obtained.
Ineligibility Criteria:
[0190] Patients currently treated with anti-inflammatory agents including glucocorticoid
therapy or NSAIDs were ineligible.
[0191] Patients without frozen or paraffin-flxed tissue available for antibody staining
for mucin were ineligible.
Clinical Location:
[0192] All patients were treated at the Pittsburgh Cancer Institute's outpatient unit or
alternatively in the Clinical Research Center out-patient unit. Some tests may have
been administered while the patient is hospitalized at Montefiore or Presbyterian
University Hospital as part of a diagnostic work-up.
Duration of study:
Assessment plan:
DTH Testing
[0194] Three separate formulations were used to test immune reactivity. The first encompassed
eight separate nonameric sequences consisting of the amino acids 1-9, 2-10, 3-11,
15-23, 16-24, 18-26, 20-28, and constituted peptides containing at least three out
of the five amino acids felt to be the likely immunogenic epitope based on prior serologic
and cellular reactivity. The second preparation encompassed the other seven nonameric
sequences. The third preparation consisted of a synthetic 105 amino acid polypeptide
spanning 5 perfectly conserved tandem repeat observed in the mucin molecule.
Dose:
[0195] Each DTH consisted of up to three separate injections of .05 ml/site injected intradermally
and consisted of 1 mcg, 10 mcg, or 100 mcg of each preparation. Equimolar concentrations
of each of the constituent nonameric sequences were prepared randomly as determined
by a statistician, and placed in syringes numbered one through nine. All testing was
performed on the posterior trunk at 2, 4, and 6 cm from the midline and each set of
three tests (total of nine) separated by at least 2 cm in the vertical axis. On the
contralateral part of the posterior trunk the multitest CMI skin test with antigens
for cellular hypersensitivity (Merieux) was applied. Each test contained a disposable
plastic applicator which was pre-loaded with seven delayed hypersensitivity skin test
antigens and a glycerine negative control for percutaneous administration: tetanus
toxoid antigen, diphtheria toxoid antigen, streptococcus antigen, old tuberculin,
candida antigen, trichophyton antigen, and proteus antigen (NDC 50361-780-80).
Schedule:
[0196] DTH for both the standard recall antigens as well as mucin derived peptides was performed
on day .0 and measured at 24, 48, and 72 hours. Skin tests were read and perpendicular
diameters for erythema and induration were recorded for each skin test.
Serum for assay of circulating mucin and detection of antibodies to mucin:
[0197] Two red-topped tubes of whole blood were drawn prior to DTH testing.
[0198] Sixty ml of heparinized whole blood (six green-topped tubes) for
in vitro T-cell reactivity to individual mucin peptides were obtained immediately prior to
DTH testing.
[0199] Six mm punch biopsies were obtained under local anesthesia for positive skin tests
to the mucin peptides and as a control to any of the positive recall antigens. If
no reactivity was observed, a biopsy of each of the highest concentrations (100ug)
applied was biopsied. One half of the punch biopsy was embedded in OCT for in
situ cytokine assays and immunohistochemistry. One half was delivered to Dr. Finn's laboratory
for expansion of T-cells.
[0200] Serum amylase, lipase, and creatinine were obtained prior to immunization and at
24, 48 and 72 hours following immunization.
Follow-up:
[0201] Patients were observed at one week and at three weeks for evidence of untoward responses
as part of the routine follow-up of the patient for their underlying disease.
Vaccine protocol:
[0202] Patients in Groups 3, regardless of the skin test result subsequently underwent vaccination
at a separate site with 100 g of p105 peptide and 5 x 107 lyphoilized TICE BCG colony
forming units (Organon Teknika Corp, Chicago, IL) in ).15 ml of saline for injection,
USP.
Schedule:
[0203] Patients were administered the vaccine at three weeks, six weeks, and nine weeks
following the initial DTH testing and re-tested with peptide as noted above for DTH
at 8 weeks. Patients were also re-assessed at 8 weeks for evidence of anti-tumor responses
using conventional radiographic criteria.
[0204] Patients underwent serum studies for amylase, lipase, and creatinine at three weeks,
six weeks, and 12 weeks.
Evaluation and management of toxicity:
[0205] All toxicity was to be graded using the common toxicity criteria. Previously unknown
or severe toxicity was to bereported to the NCI as adverse drug reactions.
[0206] NCI requirements for Phase I ADR reporting were followed. It was the responsibility
of the principal investigator to report by telephone to the IDB (301-496-7957, available
24 hours) within 24 hours of any of the following events: all life-threatening events
(Grade 4) which may be due to drug administration; all fatal events; and all first
occurrences of any previously undefined toxicity regardless of grade. Written report
was to follow within 10 days to the Investigational Drug Branch, P.O. Box 30012, Bethesda,
MD 20814.
Dose modification:
[0207] There was no dose modification in this protocol.
Diagnostic studies and therapy plan:
[0208] All pilot patients eligible for this skin test protocol following appropriate informed
consent underwent the DTH testing as noted above. Subsequent therapies may have been
administered as early as 24 hours following the completion of the skin test reading.
Therapy modification:
Pathological changes/tumor host factors: patients with evidence of an untoward responses including allergic or atopic responses
were to be treated as appropriate symptomatically. Patients with vigorous systemic
response including anaphylaxis were not to be further skin tested or subjected to
vaccination.
Study parameters to be measured (i.e. serial observations):
pre-study tests.
[0209] CBC with differential, LFTs, creatinine, BUN, amylase, and lipase.
Interim exams and frequency of evaluation:
[0210] As noted above amylase, lipase, and creatinine, as well as physical examination were
performed on patients undergoing this study at the conclusion of 72 hours of observation
for skin test reactivity.
[0211] Patients were considered off study in Group 1 or Group 2 one week after evaluation
of DTH reactivity, except for follow-up regarding death or time to disease progression.
Evaluation criteria:
[0212] The major endpoints of this study were the
in vivo and
in vitro assays of immunity against mucin peptides. The inventors also evaluated the effect
of vaccine treatment on immunity against autologous breast, colon or pancreatic cancer
and the correlation of immune responses in each category to disease response and/or
disease progression.
[0213] The immunologic endpoints in order of priority were: DTH against peptide skin tests;
cellular cytotoxicity and proliferation against individual peptides from biopsy sites
or peripheral blood; and humoral response to recombinant mucin or evidence of circulating
mucin.
[0214] The clinical parameters that were followed included: objective evidence of tumor
regression; progression for each survival; overall survival (to be compared in each
of the different groups 1, 2, and 3). (The definition of these parameters in the clinical
test were formed for evaluation of disease progression as described below.)
Complete Response:
[0215] Complete disappearance of all measurable lesions with no new lesions developing and
maintained for greater than four weeks. Complete response was dated from the time
all lesions disappear.
Partial response:
[0216] At least a 50 % reduction in the size of all measurable tumor areas as measured by
the product of the greatest length and the maximum width.
No change:
[0217] A decrease of less than 50 % or an increase of less than 25 % of the sum of the products
of the perpendicular diameters of all measurable lesions.
Progression:
[0218] A 25 % greater increase of original measurements in the sum of the products of the
perpendicular diameters of measurable lesions and/or occurrence of new lesions. If
possible, any new lesions were to be biopsied to confirm progression.
| Study parameters: |
| Prior to therapy |
Day |
Week |
| |
|
|
|
|
|
0 |
1 |
2 |
3 |
1-4 |
| History and Physical Exam |
X |
|
|
X |
|
|
|
|
X |
|
| Weight |
|
X |
|
|
|
X |
|
|
|
X |
| Tumor Measurements |
|
X |
|
|
|
X |
|
|
|
X |
| Performance Status |
X |
|
|
X |
|
|
|
|
X |
|
| CBC, platelets, differential |
|
X |
|
|
|
X |
|
|
|
X |
| Chemistry Profile, Amylase, lipase |
|
X |
|
|
|
X |
X |
|
|
X |
|
| PT/PTT |
|
X |
|
|
|
X |
|
|
|
X |
| Chest x-ray |
|
X |
|
|
|
X |
|
|
|
X |
| EKG |
|
X |
|
|
|
X |
|
|
|
X |
| Special x-rays as needed for tumor measurement |
|
X |
|
|
|
X |
|
|
|
X |
| Measurement skin test |
|
|
|
X |
X |
X |
|
|
|
|
| Punch biopsy for molecular immune testing |
|
|
|
X |
X |
|
|
|
|
|
Registration:
[0219] Patients were registered on study by the protocol nurse and/or the senior investigator
by completion of a study form, obtaining of informed consent, and application of the
first skin test.
Statistical considerations:
[0220] The primary endpoint of the study was the determination of DTH reactivity to individual
peptides. Statistical analysis involved evaluation of the degree of DTH and/or evidence
of response to the vaccine in Group 3.
Goals of the Analysis
[0221] The primary objectives of the statistical analysis were to:
(1) quantify and summarize the delayed type hypersensitivity (DTH) response to three
different preparations of mucin peptides, presented at each of three concentrations
to patients with breast, colon or pancreatic cancer;
(2) determine whether the preparations differ in terms of the strength of the responses
they elicit;
(3) determine whether there is an increasing dose-response relationship over the range
of concentrations tested;
(4) investigate possible differences in response patterns between disease groups;
(5) determine whether responses differ between treatment naive patients, patients
having completed treatment who are without apparent disease, and patients with metastatic
or untreatable cancer;
(6) correlate DTH responsiveness with the degree of infiltration of T-cell subpopulations
found adjacent to the location of injection, and to circulating mucin levels;
(7) investigate the association between DTH responsiveness to much peptides and patients'
general anergic/nonanergic status as measured by a concurrently administered panel
of standard recall antigens.
[0222] A secondary phase of the analysis considered those patients with metastatic or untreatable
disease, who following DTH testing are to receive three immunizations at three-week
intervals. Here, the principal questions of interest are:
(1) Does DTH testing subsequent to immunization indicate an increased level of responsiveness
relative to pre-immunization baselines?
(2) Are there pre-post changes in patterns of T-cell infiltration at the injection
site, or in circulating mucin levels?
(3) Are there indications of association between clinical response and baseline DTH
responsiveness?
Study Design
[0223] Patients participating in the study were drawn from the six groups shown in Fig.
B.2:

There were 30 patients entered in each of the first two treatment groups, and 60
patients entered in the third group, for a total of 120 patients on this protocol.
Each patient was then DTH tested against all nine combinations of three mucin peptide
preparations (A,B,C) and concentrations (lmcg, 10 mcg, 100 mcg).
[0224] Specific descriptions of the peptide preparations are reported above. Each of the
nine tests was administered by intradermal injection of .05ml, with the order and
relative placement of the injections randomized for each patient to avoid interactive
biases that could otherwise conceivably occur. The syringes used for injection were
preloaded and blinded in such a way that neither the patients, the personnel performing
the injections, nor those responsible for measurement of induration had knowledge
of the placement of the tests.
[0225] The structure of the study design was therefore factorial, with two between-patient
factors (Disease and Treatment Status) and two within-patient factors (Peptide Preparation
and Concentration). DTH response was assessed at 24 and 48h following injection (so
that time could be considered a third within-subject factor). Strength of the response
was quantified by determining the product of the largest diameter of the induration
and its perpendicular (proportional to the area of induration) at each time point.
For purposes of analysis the maximal area of induration over the 72h observation period
served as the primary endpoint of interest.
Analysis Methods:
[0226] Analysis of DTH Response: The statistical methods which was most appropriate for
analysis depended strongly on the nature of the DTH responses observed over the course
of the study. If the large majority of patients measurably responded to each of the
peptide preparations, then the treatment of the area of induration as an interval-scaled
variable would be indicated. In this case, the goals of the analysis specified above
may be addressed by use of repeated measures analysis of variance methods described
in the following references: Wiper, BJ, Statistical Principles in Experimental Design,
1971, McGraw-Hill, New York, NY; Crowder, MJ and Hand, DJ Analysis of Repeated Measures,
1990, Chapman and Hall, London; Milliken, George A., and Johnson, Dallas E., Analysis
of Messy Data, Vol. 1: Designed Experiments, 1984, Wadsworth, Belmont CA.
[0227] On the other hand, if positive DTH responses are noted in only a fraction of patients,
with a significant proportion of nonresponders, the usual methods of repeated measures
analysis would not be appropriate. Instead, the approach taken would involve the classification
of responses into ordered categories. Depending on the nature of the data at hand,
the best method of categorization may vary from a simple "No Response"/"Response"
dichotimization to a more complicated set of ordered categories, e.g. "No Response",
"Response only at 100 mcg", "Response only at > = 10 mcg", "Response at > = 1 mcg".
Methods of repeated measures analysis appropriate to categorical responses are described
in Prowder, MJ and Hand, DJ Analysis of Repeated Measures, 1990, Chapman and Hall,
London, and in Agresti, Alan, Categorical Data Analysis, 1990, John Wiley & Sons,
New York, NY. For example, a formal test of equivalence of response profiles across
the three peptides may be carried out by use of the CMH ANOVA statistic applied to
patient-stratified peptide by-response contingency tables.
[0228] It is not unlikely that the peptide formulation consisting of the amino acids 1-9,
2-10,3-11,15-23,16-24, 18-26 and 20-28 would typically result in measurable responses
suitable for analysis on an interval scale, while the remaining preparations would
produce few responses. In such a case, following initial analyses of an ordinal nature
formally comparing the three preparations, subsequent and more detailed analysis of
the first preparation would be carried out by means of classic repeated measures methods.
[0229] Analysis of Vaccination Effects: In this phase of the investigation, postvaccination
DTH responses were to be compared with baseline responses in the 10 metastatic breast
cancer patients and the 10 metastatic pancreatic cancer patients, in order to determine
whether vaccination is effective in enhancing DTH responsiveness. Formal statistical
tests of effect were to be carried out by classic or categorical repeated measures
analysis, as appropriate. Tests for the occurrence of post-vaccination changes in
T-cell infiltrate levels and circulating mucin levels were similarly conducted.
[0230] It was also of interest to investigate the possible association of clinical responses
with pre-vaccination parameters, and in particular with baseline DTH response. This
was done by means of logistic regression modeling. Due to the limited sample size
involved in this phase of the investigation, and because the frequency of clinical
response cannot be expected to be large, p-values were generated by means of exact
permutation tests. For these same reasons, it was unlikely that statistically significant
association would be detected here, even if in fact the true correlation between clinical
response and prior DTH response is large.
Time frame:
[0231] A total of 120 patients entered into this study. This required over a one year time
period that one to two patients be entered per week. Two to four patients with pancreatic
cancer were seen each week and well over 10-20 patients with breast cancer. It was
anticipated that this protocol may be completed within six months and that other questions
may need to be addressed.
[0232] While the foregoing invention has been described in some detail for purposes of clarity
and understanding, it will be clear to one skilled in the art from a reading of this
disclosure that various changes in form and detail can be made without departing from
the scope of the invention defined by the claims.
Table 1.
| Sequences Analysis of Human Mucin Tandem Repeats |
| Mucin Gene |
Muc-1 |
Muc-2 |
Muc-3 |
Muc-4 |
| # Amino Acids/repeat |
20 |
24 |
17 |
16 |
| % Proline |
25 |
21 |
6 |
6 |
| % Threonine |
15 |
62 |
41 |
25 |
| % Glycine |
20 |
4 |
0 |
0 |
| % Ser + Thr |
25 |
62 |
70 |
50 |
| # Turns/Repeata |
3 |
2 |
1 1 |
|
| a: Predicted by Chou and Fasman rules |
Table 2.
| Monocolonal Antibody Recognition of Mucin Peptides |
| Antibody |
Epitope |
Reactivity in ELISA |
| |
|
20mer |
40mer |
60mer |
| HMFG2 |
DTR |
4.5 |
17 |
17 |
| 139H2 |
CORE |
2.2 |
30 |
34 |
| 175C5 |
? |
2.3 |
15 |
36 |
| 201E9 |
? |
29.0 |
100 |
121 |
| BC1 |
(A)PDTR |
7.0 |
27 |
14 |
| BC2 |
(A)PDTR |
2.7 |
17 |
18 |
| BC3 |
(A)PDTR |
4.8 |
100 |
83 |
Table 3.
| Molecular Dimensions of Mucin 60 Amino Acid Peptide |
| Intrinsic Viscosity [η]ml/g |
7.7 |
| Axial Ratio (a/b) from [η]ml/g |
9.2 |
| Axial Ratio (a/b) from Molecular Graphics |
9.7 |
| Length (A) per TR from Molecular Graphics |
35 |
Table 5.
| Mass Analysis of Synthetic peptides |
| Gene |
No. Copies |
Predicted MW |
Actual MW |
| mucin |
1 |
1887 |
1886 |
| mucin |
2 |
3756 |
3756 |
| mucin |
3 |
5625 |
5625 |
| mucin |
4 |
7495 |
7492 |
| mucin |
5.25 |
9780 |
9778 |
| |
|
|
|
| FeLV |
|
|
|
| PRN60 |
1 |
6305 |
6303 |
| PRN42 |
1 |
4483 |
4482 |
| |
|
|
|
| H2D8 |
5 |
5525 |
5526 |
| H2D8 |
8 |
8829 |
8834 |
| |
|
|
|
| H2DMUC7 |
7 |
7805 |
7806 |
TABLE 6
| ANTI-MUCIN CTLp PRE- AND POST-VACCINATION |
| PATIENT |
CTLp |
| |
pre- |
post- |
| P-3 #2 |
1/1 069 035 |
1/614 384 |
| C-3 #2 |
1/25 419 |
1/17 966 |
| B-3 #1 |
1/337 287 |
1/203 493 |
| P-3 #1 |
1/236 981 |
1/161 318 |
TABLE 7
| ANTI-MUCIN ANTIBODY PRE- AND POST-VACCINATION |
| PATIENT |
IgM |
I gG |
| |
pre- |
post- |
pre- |
post- |
| C-3 #10 |
- |
- |
- |
- |
| B-3#6 |
- |
- |
- |
- |
| C-3 #9 |
- |
- |
- |
- |
| P-3 #8 |
+ |
+ |
- |
- |
| P-3 #7 |
- |
- |
+ |
+ |
| P-3 #1 |
- |
- |
- |
- |
| C-3 #7 |
++ |
++ |
- |
- |
| B-3 #4 |
- |
- |
+ |
+ |
| C-3 #2 |
+ |
+ |
- |
- |
| C-3 #13 |
++ |
++ |
- |
- |
| B-3 #1 |
- |
+ |
- |
+ |
| P-3 #3 |
- |
- |
+ |
+ |
TABLE 9 :
| PRE-VACCINATION DTH IN COLON CANCER PATIENTS |
| PATIENT |
9mer (+PDTRP) |
9mer(-PDTRP) |
105mer |
| C-3 #21 |
+ |
- |
++ |
| C-3 #22 |
- |
+ |
+ |
| C3 #23 |
++ |
++ |
+ |
| C-3 #24 |
+++ |
++ |
- |
| C-3 #10 |
- |
++ |
+ |
| C-3 #26 |
++++ |
- |
++ |
| C-3 #14 |
++ |
- |
+ |
| C-3 #17 |
++ |
- |
- |
| C-3 #2 |
+ |
- |
+ |
| C-3 #7 |
++ |
- |
+ |
| C-3 #5 |
++ |
+ |
+ |
| C-3 #12 |
+ |
- |
++ |
| C-3 #20 |
+ |
- |
+ |
| C-3 #18 |
- |
+ |
++ |
| C-3 #13 |
+ |
++ |
- |
| C-3 #3 |
++ |
- |
+ |
| C-3 #4 |
- |
+ |
++ |
| C-3 #1 |
- |
++ |
+++ |
| C-3 #19 |
+ |
+ |
++ |
| |
14/19 |
10/19 |
16/19 |
| |
|
|
|
| C-3 #8 |
- |
- |
- |
| C-3 #25 |
- |
- |
- |
| C-3 #9 |
- |
- |
- |
| C-3 #6 |
- |
- |
- |
| C-3 #16 |
- |
- |
- |
| C-3 #11 |
+ |
+ |
+ |
TABLE 10 :
| PRE-VACCINATION DTH IN PANCREATIC CANCER PATIENTS |
| PATIENT |
9mer (+PDTRP) |
9mer(-PDTRP) |
105mer |
| P-3 #18 |
+ |
+++ |
+++ |
| P-1 #1 |
++ |
- |
++ |
| P-3 #5 |
- |
- |
++ |
| P-3 #19 |
- |
+ |
+++ |
| P-3 #9 |
+ |
- |
++ |
| P-3 #12 |
++ |
++ |
+ |
| P-3 #3 |
+ |
- |
++ |
| P-3 #7 |
++ |
- |
- |
| P-3 #8 |
+ |
+++ |
+++ |
| P-3 #15 |
+ |
+++ |
++ |
| P-3 #14 |
+++ |
+++ |
+ |
| P-3 #1 |
- |
- |
++ |
| P3 #10 |
+ |
++ |
+++ |
| P-3 #17 |
++ |
+ |
+ |
| P-2 #1 |
+ |
- |
+ |
| P-3 #4 |
+++ |
- |
- |
| |
15/17 |
10/17 |
17/17 |
| |
|
|
|
| P-3 #20 |
- |
- |
- |
| P-3 #13 |
- |
- |
- |
| P-3 #16 |
- |
- |
- |
| P-3 #16 |
+ |
+ |
+ |
| P-3 #11 |
+ |
+ |
+ |
TABLE 11 :
| PRE-VACCINATION DTH IN BREAST CANCER PATIENTS |
| PATIENT |
9mer (+PDTRP) |
9mer(-PDTRP) |
105mer |
| B-3 #2 |
- |
++ |
+ |
| B-3 #7 |
- |
- |
+ |
| B-3 #6 |
- |
+ |
++ |
| B-3 #1 |
- |
- |
+ |
| B-3 #8 |
+ |
+ |
- |
| |
1/5 |
3/5 |
4/5 |
| |
|
|
|
| B-3 #3 |
- |
- |
- |
| B-3 #5 |
- |
- |
- |
| B-3 #4 |
- |
- |
- |